互白素-17 抑制剂和早期主要心血管不良事件
Maxime Raby1,2, Frederic Balusson1,3, Emmanuel Oger1,3
1Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en 13 Santé, Environnement et Travail)-UMR_S 1085, Rennes, France.
JAMA dermatology
|September 3, 2025
概括
开始治疗牛皮的17A (IL-17) 抑制剂并没有显著增加主要心血管不良事件 (MACE) 的风险. 这一发现适用于不同患者的心血管风险水平, 表明这些生物药物对心脏健康是安全的.
科学领域:
- 心血管医学
- 皮肤病学
- 免疫学
背景情况:
- 生物药物对牛皮的心血管影响尚未完全了解.
- 抑制T辅助细胞通路可能会破坏动脉样硬化斑块的稳定,可能会增加主要心血管不良事件 (MACE).
研究的目的:
- 评估是否启动干白素 (IL) - 17A抑制剂会触发MACE.
- 评估IL- 17A抑制剂启动与MACE之间的关联,使用瘤坏死因子 (TNF) -α抑制剂作为比较剂.
主要方法:
- 一项病例时间控制研究利用了法国国家医疗保险数据库 (2016-2021年).
- 包括开始使用IL-17A抑制剂 (secukinumab,ixekizumab, brodalumab) 或TNF-α抑制剂 (adalimumab,etanercept) 的患者.
- 与之前的6个月参考期相比,在开始治疗后的6个月内评估MACE风险.
主要成果:
- 在34241名服用IL-17A抑制剂的人群中,分析了381个MACE.
- 与TNF-α抑制剂相比,启动IL- 17A抑制剂与MACEs没有显著的关联 (OR,1. 40 [95% CI,0. 77-2. 54]).
- 在敏感性分析和患者心血管风险水平上,结果保持一致.
结论:
- 在MACE和IL-17A抑制剂的启动之间没有发现显著的关联.
- 这项研究表明IL-17A抑制剂与牛皮患者心血管风险的增加无关.
- 不能完全排除风险的轻微增加,因此需要持续监测.
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