晚期治疗性结肠炎患者的血栓栓塞风险:现实世界的数据分析
Yu Nishida1, Shuhei Hosomi1, Koji Fujimoto1
1Department of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
患有性结肠炎 (UC) 的患者面临更高的血栓风险. 与TNF抑制剂相比,治疗UC的维多利祖马布显示静脉血栓栓塞 (VTE) 和心血管事件的风险较低.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
- 流行病学 流行病学
背景情况:
- 性结肠炎 (UC) 患者患血栓栓塞的风险增加.
- 针对UC的先进疗法 (ADT) 对血栓栓塞事件的比较风险尚未确定.
研究的目的:
- 为了比较静脉血栓塞栓瘤 (VTE),心血管事件 (CVE) 和主要不良心血管事件 (MACE) 的风险,UC患者开始使用瘤坏死因子 (TNF) 抑制剂,vedolizumab或tofacitinib治疗.
- 评估不同UC先进疗法的关于血栓和心血管风险的安全性.
主要方法:
- 使用日本医学数据视觉索赔数据库进行回顾性队列研究.
- 对UC患者开始使用TNF抑制剂,vedolizumab或tofacitinib治疗的分析.
- 对VTE,CVE和MACE的累积发病率和危险比率 (HRs) 的评估,用托法西提尼布剂量作为时间变化的共变量建模.
主要成果:
- 与TNF抑制剂相比,维多利祖马布的使用与VTE (HR 0.50) 和CVE (HR 0.47) 的风险显著降低.
- 与TNF抑制剂相比,托法西替尼 (5mg和10mg两次) 在VTE,CVE或MACE风险上没有显著差异.
- 同时使用5-氨基酸与VTE的发病率降低有关.
结论:
- 维多利祖马布在UC患者中相对于TNF抑制剂,具有有利的血栓栓塞和心血管安全概况.
- 与TNF抑制剂相比,托法西替尼在研究的剂量中没有提高VTE,CVE或MACE的风险.
- 5-氨基酸可能会在UC患者中对VTE产生保护作用,为高血栓风险患者的治疗决策提供信息.
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