风湿性免疫相关的不良事件:免疫检查点抑制剂治疗和健康差异的分支
Laura Kobashigawa1, Nicole Zagelbaum1, Katherine Ruddy1
1Division of Rheumatology, University of Southern California Keck School of Medicine, Los Angeles, USA.
Cureus
|September 22, 2025
概括
免疫检查点抑制剂 (ICI) 治疗可以导致风湿性免疫相关不良事件 (irAEs). 公立医疗中心的患者,主要是西班牙裔,与私人中心相比,对irAEs的风湿病学家转诊率明显较低,这引发了对医疗保健差异的担忧.
科学领域:
- 在瘤学瘤学.
- 类风湿病学 类风湿病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 免疫检查点抑制剂 (ICI) 已经改变了癌症治疗,但可能导致与免疫相关的不良事件 (irAEs).
- 风湿性IRAE是一个重大问题,特别是在少数民族人口中,这些人在当前的研究中代表性不足.
- 了解IRES管理中的差异对于公平的癌症护理至关重要.
研究的目的:
- 调查与风湿性免疫相关不良事件 (irAEs) 和风湿病学家转诊率之间的差异,主要为西班牙裔人口服务的公共医疗中心和私人医疗中心之间的差异.
- 在这两种不同的医疗保健环境中比较患有风湿性IRAE的患者的特征和治疗方法.
主要方法:
- 在2015年5月至2021年5月期间,在两个医疗中心 (公共和私人) 进行了18岁以上患者用ICI治疗的医疗记录的回顾性审查.
- 两个中心之间的患者人口统计,irAE发展和转诊模式的比较.
- 分析的重点是确定类风湿性IRAE的发病率和管理方面的差异.
主要成果:
- 在这两个中心的患者中观察到风湿性IRAE,主要是关节炎和肌肉炎.
- 与私人医疗中心的患者相比,公共医疗中心的患者更有可能是西班牙裔,并且与私人医疗中心的患者相比,被转介给风湿病学家的可能性要大得多.
- 对于患有类风湿性IRAE的患者,机构之间没有发现癌症结局的显著差异.
结论:
- 公共医疗中心的风湿性IRAE的风湿学家转诊率较低表明潜在的医疗保健差异.
- 需要对不同患者群体进行进一步的研究,以确保在不同医疗机构中公平地管理irAEs.
- 解决这些差异对于改善所有接受ICI治疗的癌症患者的结果至关重要.
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