带状疹的整体和比较风险与先进疗法在患有炎症性肠道疾病的患者
Dhruv Ahuja1,2, Soo-Kyung Park1,3, Kuan-Hung Yeh4
1Division of Gastroenterology, Department of Medicine, University of California san Diego, La Jolla, California, USA.
与其他先进疗法相比,Janus 激酶 (JAK) 抑制剂在炎症性肠病 (IBD) 患者中显著增加带状带风险. 这一发现凸显了在启动用于IBD治疗的JAK抑制剂时需要仔细监测和风险评估的必要性.
科学领域:
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 炎症性肠道疾病 (IBD) 的先进疗法与带状疹的风险增加有关.
- 了解不同高级治疗类别中带状疹的比较风险对于患者安全至关重要.
研究的目的:
- 为了比较各种先进疗法治疗的IBD患者中带状疹的发病率和风险.
- 确定特定的先进疗法,使得带状疹的风险更高.
主要方法:
- 对21,675名开始使用新的先进治疗方法的IBD患者进行了回顾性队列研究 (2016-2022年).
- 先进的疗法包括:瘤坏死因子 (TNF) 抗剂,抗整合素,抗干细胞蛋白,简氏激酶 (JAK) 抑制剂和-1酸盐受体 (S1PR) 调节剂.
- 基于多项性倾向得分的治疗权重反向概率 (IPTW) 和权重的Cox模型被用于比较带状风险.
主要成果:
- 带状疹每100人/年的发病率 (IR) 根据治疗方式有所不同:JAK抑制剂 (3.3),S1PR调节剂 (2.0),抗整体素 (1.4),抗介质蛋白 (1.2),TNF抗剂 (1.0).
- 与TNF抗剂 (HR 2.19),抗整体素 (HR 1.87) 和抗介质蛋白 (HR 1.70) 相比,JAK抑制剂与带状疹的风险显著增加有关.
- 复杂的带状疹也显示了使用JAK抑制剂 (0.9) 和S1PR调节剂 (1.0) 的更高发病率.
结论:
- 氏激酶 (JAK) 抑制剂在IBD患者中与其他先进疗法相比,带状疹的风险高出1.7-2.2倍.
- 这些发现强调了风险分层和潜在的预防措施的重要性带状疹在开始治疗JAK抑制剂治疗IBD的患者中.
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