针对性合成DMARDs的周产期使用和自身免疫性疾病中的母婴结局:基于人口的队列研究
Vienna Cheng1, Eric C Sayre2, Neda Amiri3
1Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada; Collaboration for Outcomes Research and Evaluation, Vancouver, British Columbia, Canada; Arthritis Research Canada, Vancouver, British Columbia, Canada.
Journal of autoimmunity
|March 4, 2026
概括
这项研究调查了在怀孕期间的针对性合成疾病修饰性抗风湿药物 (tsDMARDs),发现TSDMARD暴露与早产之间存在显著的关联. 需要更多的研究来确认怀孕期间自身免疫性疾病管理的安全性.
科学领域:
- 类风湿病学 类风湿病学
- 产科 产科 产科 产科 产科
- 药理学 药理学是指药理学的学科.
背景情况:
- 针对性合成疾病修饰性抗风湿药物 (tsDMARDs) 对于控制自身免疫性疾病至关重要.
- 关于 tsDMARDs 产周安全性的数据有限,这阻碍了怀孕期间的临床决策.
研究的目的:
- 分析患有自身免疫性疾病的孕妇中tsDMARD使用模式.
- 评估围产期TSDMARD暴露与母亲和新生儿结局之间的关联.
主要方法:
- 在加拿大不列颠哥伦比亚省 (2002-2022) 使用了基于人口的管理健康数据库.
- 包括患有自身免疫性疾病的女性和至少一个怀孕,将TSDMARD暴露的怀孕与未暴露的怀孕相匹配.
- 使用费舍尔的精确测试检查了母体,胎儿/新生儿和综合结果.
主要成果:
- 在TSDMARD暴露和早产之间发现了显著的关联 (未经调整的OR 13.45,p=0.01).
- 对于妊娠糖尿病和剖腹产分娩,观察到非显著的关联.
- 在19个暴露的怀孕中,有36.8%的孕妇暴露于1年的孕前期,并在第二个三个月中停止治疗.
结论:
- 基于人口的数据可以有效地解决怀孕期间罕见暴露的研究中的混问题,如tsDMARDs.
- 这项研究提供了关于 tsDMARDs 产周安全性的关键证据.
- 进一步汇集数据对于加强怀孕期间新兴药物的证据至关重要.
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