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AP&T: 定期使用质子泵抑制剂和女性类风湿性关节炎的风险

2020-07-20 MedSci原创 MedSci原创

质子泵抑制剂(PPI)对肠道微生物组具有重要影响,进而可能增加类风湿关节炎(RA)的风险。本项研究旨在评估PPI的常规使用和RA的风险。

背景

质子泵抑制剂(PPI)对肠道微生物组具有重要影响,进而可能增加类风湿关节炎(RA)的风险。本项研究旨在评估PPI的常规使用和RA的风险。

 

方法

本项研究对美国护士进行了回顾性分析,暴露因素是过去两年中定期使用的PPI。RA的诊断通过美国医疗保监局的相关定义进行。研究人员通过对潜在混杂因素进行时间依赖性Cox回归调整,估计了危险比(HRs)和置信区间(CIs)。

 

结果

本项研究共记录了421例RA患者,随访时间超过1753879人年。与非常规使用者相比,常规PPI使用者的RA风险高44%(调整后HR = 1.44; 95%CI,1.10-1.89)。RA的风险随着使用PPI的总持续时间而增加(P趋势= 0.008)。与非常规使用者相比,使用> 0至4年的女性的校正后HR为1.22(95%CI,0.93-1.62),使用> 4年的女性为1.73(95%CI,1.14至2.61)。

 

结论

定期使用PPI与女性患RA的风险增加有关,在使用PPI持续时间较长的个体中观察到较高的风险。

 

原始出处:

Jinqiu Yuan. Et al. Regular use of proton pump inhibitor and risk of rheumatoid arthritis in women: a prospective cohort study. Alimentary Pharmacology and Therapeutics.2020.

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    2021-03-31 jklm09
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    2020-07-21 lmm397
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1667375, encodeId=89f4166e3751e, content=<a href='/topic/show?id=03ab923565b' target=_blank style='color:#2F92EE;'>#质子泵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92356, encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Mon Dec 28 20:51:28 CST 2020, time=2020-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1852438, encodeId=77f5185243837, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=152, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Wed Mar 31 14:51:28 CST 2021, time=2021-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266216, encodeId=dcaa126621611, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Jul 21 23:51:28 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334251, encodeId=24de133425109, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Tue Jul 21 23:51:28 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483692, encodeId=6dbd1483692e1, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Tue Jul 21 23:51:28 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803483, encodeId=91ee80348347, content=好评, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=acee5401612, createdName=ms7000001773953003, createdTime=Mon Jul 20 14:38:25 CST 2020, time=2020-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803475, encodeId=f4e28034e5ef, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=142, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=42633007966, createdName=983929547, createdTime=Mon Jul 20 13:18:32 CST 2020, time=2020-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803447, encodeId=3fe280344e14, content=学到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d4f25135302, createdName=14664e41m61暂无昵称, createdTime=Mon Jul 20 10:17:50 CST 2020, time=2020-07-20, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1667375, encodeId=89f4166e3751e, content=<a href='/topic/show?id=03ab923565b' target=_blank style='color:#2F92EE;'>#质子泵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92356, encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Mon Dec 28 20:51:28 CST 2020, time=2020-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1852438, encodeId=77f5185243837, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=152, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Wed Mar 31 14:51:28 CST 2021, time=2021-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266216, encodeId=dcaa126621611, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Jul 21 23:51:28 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334251, encodeId=24de133425109, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Tue Jul 21 23:51:28 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483692, encodeId=6dbd1483692e1, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Tue Jul 21 23:51:28 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803483, encodeId=91ee80348347, content=好评, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=acee5401612, createdName=ms7000001773953003, createdTime=Mon Jul 20 14:38:25 CST 2020, time=2020-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803475, encodeId=f4e28034e5ef, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=142, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=42633007966, createdName=983929547, createdTime=Mon Jul 20 13:18:32 CST 2020, time=2020-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803447, encodeId=3fe280344e14, content=学到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d4f25135302, createdName=14664e41m61暂无昵称, createdTime=Mon Jul 20 10:17:50 CST 2020, time=2020-07-20, status=1, ipAttribution=)]
    2020-07-20 ms7000001773953003

    好评

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1667375, encodeId=89f4166e3751e, content=<a href='/topic/show?id=03ab923565b' target=_blank style='color:#2F92EE;'>#质子泵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92356, encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Mon Dec 28 20:51:28 CST 2020, time=2020-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1852438, encodeId=77f5185243837, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=152, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Wed Mar 31 14:51:28 CST 2021, time=2021-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266216, encodeId=dcaa126621611, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Jul 21 23:51:28 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334251, encodeId=24de133425109, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Tue Jul 21 23:51:28 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483692, encodeId=6dbd1483692e1, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Tue Jul 21 23:51:28 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803483, encodeId=91ee80348347, content=好评, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=acee5401612, createdName=ms7000001773953003, createdTime=Mon Jul 20 14:38:25 CST 2020, time=2020-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803475, encodeId=f4e28034e5ef, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=142, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=42633007966, createdName=983929547, createdTime=Mon Jul 20 13:18:32 CST 2020, time=2020-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803447, encodeId=3fe280344e14, content=学到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d4f25135302, createdName=14664e41m61暂无昵称, createdTime=Mon Jul 20 10:17:50 CST 2020, time=2020-07-20, status=1, ipAttribution=)]
    2020-07-20 983929547

    很好

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1667375, encodeId=89f4166e3751e, content=<a href='/topic/show?id=03ab923565b' target=_blank style='color:#2F92EE;'>#质子泵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92356, encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Mon Dec 28 20:51:28 CST 2020, time=2020-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1852438, encodeId=77f5185243837, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=152, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Wed Mar 31 14:51:28 CST 2021, time=2021-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266216, encodeId=dcaa126621611, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Jul 21 23:51:28 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334251, encodeId=24de133425109, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Tue Jul 21 23:51:28 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483692, encodeId=6dbd1483692e1, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Tue Jul 21 23:51:28 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803483, encodeId=91ee80348347, content=好评, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=acee5401612, createdName=ms7000001773953003, createdTime=Mon Jul 20 14:38:25 CST 2020, time=2020-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803475, encodeId=f4e28034e5ef, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=142, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=42633007966, createdName=983929547, createdTime=Mon Jul 20 13:18:32 CST 2020, time=2020-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803447, encodeId=3fe280344e14, content=学到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d4f25135302, createdName=14664e41m61暂无昵称, createdTime=Mon Jul 20 10:17:50 CST 2020, time=2020-07-20, status=1, ipAttribution=)]
    2020-07-20 14664e41m61暂无昵称

    学到了

    0

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近日研究人员考察了COVID-19大流行期间,自身免疫性风湿性疾病患者的COVID-19易感性。

Eur Respir J:甲氨蝶呤和类风湿关节炎相关的间质性肺疾病

该研究的结果表明RA患者MTX的使用与RA-ILD的风险增加无关,但在MTX治疗的患者中ILD诊断延迟。

BMJ:不同生物药物联合甲氨蝶呤治疗类风湿关节炎的疗效差异研究

研究发现对于甲氨蝶呤治疗失败的类风湿关节炎患者,不同的生物药物与甲氨蝶呤联合用药仅在益处和危害方面存在细微差异

EULAR 2020:头对头III期研究证实AbbVie的JAK1抑制剂upadacitinib治疗类风湿关节炎,优于CTLA-4-Fc融合蛋白abatacept

接受upadacitinib的患者中有30%在第12周达到临床缓解(DAS28-CRP <2.6),而接受abatacept的患者为13%

Nature:类风湿关节炎的关键治疗新靶点被发现

类风湿性关节炎(Rheumatoid arthritis,简称RA)是一个主要影响关节的长期慢性疾病。它通常导致关节发热、肿胀和疼痛。类风湿性关节炎的成因不明,目前认为可能与机体免疫反应和炎性反应异常

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