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Dig Dis & Sci:炎症性肠病患者使用抗肿瘤坏死因子会增加银屑病相关的发生率

2018-06-24 MedSci MedSci原创

有越来越多地报道证明抗-TNF制剂对患有银屑病的CD患者治疗效果欠佳。本项研究就将炎症性肠病患者中大量使用抗TNF相关性银屑病的患病率和临床特征进行分析。

背景
有越来越多地报道证明抗-TNF制剂对患有银屑病的CD患者治疗效果欠佳。本项研究就将炎症性肠病患者中大量使用抗TNF相关性银屑病的患病率和临床特征进行分析。

方法
研究人员对在IBD中心治疗的所有患者进行回顾性分析,时间跨度为2004年和2016年。并详细回顾了IBD治疗中促进银屑病的发生发展情况。

结果
在用抗TNF(英夫利昔单抗或阿达木单抗)治疗的676名患者中,银屑病的的发病率为10.7%(N= 72)。女性(OR 1.88 [95%CI 1.12-3.17],p= 0.017),累及上消化道的克罗恩病(OR 3.03 [95 %CI 1.06-8.33],p= 0.039)与银屑病发展有关。发生银屑病的中位时间为抗TNF开始569天,阿达木单抗相对于英夫利昔单抗发生银屑病的患者发病较早(457 vs. 790.5天,p= 0.008)。总体而言,在72病例中银屑病需要停止抗-TNF占26%。斑块型银屑病是银屑病最常见的类型(75%)。局部皮质类固醇是银屑病最常见的治疗方法。

结论
本项研究展示了银屑病与克罗恩病疾病特点的相关关系。然而仍然需要更多的前瞻性研究和遗传分析来评估这个巨大的临床问题。

原始出处:

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  5. 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GetPortalCommentsPageByObjectIdResponse(id=326712, encodeId=80f7326e12ee, content=^_^^_^^_^^_^, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Swp2ehfHpiciczeTntUyQOlIGMzQ705ic67sdMTVMbwTv7KbmlUvxrGvRSvQZjPkz7ib5tEDfIaORgczPtmHDpwojg/0, createdBy=c54b2163125, createdName=wqkm, createdTime=Sun Jun 24 21:45:19 CST 2018, time=2018-06-24, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1826457, encodeId=357d182645e6f, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Tue Sep 04 10:46:00 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2012727, encodeId=07482012e27b5, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Sun May 12 10:46:00 CST 2019, time=2019-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1599985, encodeId=f3031599985eb, content=<a href='/topic/show?id=508e6e03203' target=_blank style='color:#2F92EE;'>#炎症性肠病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67032, encryptionId=508e6e03203, topicName=炎症性肠病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9fa18776644, createdName=huangshifeng, createdTime=Tue Jun 26 07:46:00 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1565808, encodeId=cdf11565808dd, content=<a href='/topic/show?id=61785564089' target=_blank style='color:#2F92EE;'>#抗肿瘤坏死因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55640, encryptionId=61785564089, topicName=抗肿瘤坏死因子)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1e7415021136, createdName=zblhy, createdTime=Tue Jun 26 07:46:00 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1559799, encodeId=32c21559e99b0, content=<a href='/topic/show?id=61785564089' target=_blank style='color:#2F92EE;'>#抗肿瘤坏死因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55640, encryptionId=61785564089, topicName=抗肿瘤坏死因子)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1e7415021136, createdName=zblhy, createdTime=Tue Jun 26 07:46:00 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547149, encodeId=d44c154e149ef, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Tue Jun 26 07:46:00 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1485455, encodeId=34771485455f3, content=<a href='/topic/show?id=3879828e19d' target=_blank style='color:#2F92EE;'>#肿瘤坏死因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82871, encryptionId=3879828e19d, topicName=肿瘤坏死因子)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=43077999209, createdName=ms7524819409032184, createdTime=Tue Jun 26 07:46:00 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1362887, encodeId=f47b136288ee5, content=<a href='/topic/show?id=b723414321c' target=_blank style='color:#2F92EE;'>#坏死#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41432, encryptionId=b723414321c, topicName=坏死)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0e3195, createdName=millore, createdTime=Tue Jun 26 07:46:00 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327026, encodeId=08f732e026f4, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Jun 26 01:30:31 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326712, encodeId=80f7326e12ee, content=^_^^_^^_^^_^, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Swp2ehfHpiciczeTntUyQOlIGMzQ705ic67sdMTVMbwTv7KbmlUvxrGvRSvQZjPkz7ib5tEDfIaORgczPtmHDpwojg/0, createdBy=c54b2163125, createdName=wqkm, createdTime=Sun Jun 24 21:45:19 CST 2018, time=2018-06-24, status=1, ipAttribution=)]
    2018-06-26 millore
  9. [GetPortalCommentsPageByObjectIdResponse(id=1826457, encodeId=357d182645e6f, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Tue Sep 04 10:46:00 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2012727, encodeId=07482012e27b5, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Sun May 12 10:46:00 CST 2019, time=2019-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1599985, encodeId=f3031599985eb, content=<a href='/topic/show?id=508e6e03203' target=_blank style='color:#2F92EE;'>#炎症性肠病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67032, encryptionId=508e6e03203, topicName=炎症性肠病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9fa18776644, createdName=huangshifeng, createdTime=Tue Jun 26 07:46:00 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1565808, encodeId=cdf11565808dd, content=<a href='/topic/show?id=61785564089' target=_blank style='color:#2F92EE;'>#抗肿瘤坏死因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55640, encryptionId=61785564089, topicName=抗肿瘤坏死因子)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1e7415021136, createdName=zblhy, createdTime=Tue Jun 26 07:46:00 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1559799, encodeId=32c21559e99b0, content=<a href='/topic/show?id=61785564089' target=_blank style='color:#2F92EE;'>#抗肿瘤坏死因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55640, encryptionId=61785564089, topicName=抗肿瘤坏死因子)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1e7415021136, createdName=zblhy, createdTime=Tue Jun 26 07:46:00 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547149, encodeId=d44c154e149ef, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Tue Jun 26 07:46:00 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1485455, encodeId=34771485455f3, content=<a href='/topic/show?id=3879828e19d' target=_blank style='color:#2F92EE;'>#肿瘤坏死因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82871, encryptionId=3879828e19d, topicName=肿瘤坏死因子)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=43077999209, createdName=ms7524819409032184, createdTime=Tue Jun 26 07:46:00 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1362887, encodeId=f47b136288ee5, content=<a href='/topic/show?id=b723414321c' target=_blank style='color:#2F92EE;'>#坏死#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41432, encryptionId=b723414321c, topicName=坏死)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0e3195, createdName=millore, createdTime=Tue Jun 26 07:46:00 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327026, encodeId=08f732e026f4, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Jun 26 01:30:31 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326712, encodeId=80f7326e12ee, content=^_^^_^^_^^_^, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Swp2ehfHpiciczeTntUyQOlIGMzQ705ic67sdMTVMbwTv7KbmlUvxrGvRSvQZjPkz7ib5tEDfIaORgczPtmHDpwojg/0, createdBy=c54b2163125, createdName=wqkm, createdTime=Sun Jun 24 21:45:19 CST 2018, time=2018-06-24, status=1, ipAttribution=)]
    2018-06-26 1209e435m98(暂无昵称)

    学习了.谢谢分享

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1826457, encodeId=357d182645e6f, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Tue Sep 04 10:46:00 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2012727, encodeId=07482012e27b5, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Sun May 12 10:46:00 CST 2019, time=2019-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1599985, encodeId=f3031599985eb, content=<a href='/topic/show?id=508e6e03203' target=_blank style='color:#2F92EE;'>#炎症性肠病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67032, encryptionId=508e6e03203, topicName=炎症性肠病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9fa18776644, createdName=huangshifeng, createdTime=Tue Jun 26 07:46:00 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1565808, encodeId=cdf11565808dd, content=<a href='/topic/show?id=61785564089' target=_blank style='color:#2F92EE;'>#抗肿瘤坏死因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, 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beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Tue Jun 26 07:46:00 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1485455, encodeId=34771485455f3, content=<a href='/topic/show?id=3879828e19d' target=_blank style='color:#2F92EE;'>#肿瘤坏死因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82871, encryptionId=3879828e19d, topicName=肿瘤坏死因子)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=43077999209, createdName=ms7524819409032184, createdTime=Tue Jun 26 07:46:00 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1362887, encodeId=f47b136288ee5, content=<a href='/topic/show?id=b723414321c' target=_blank style='color:#2F92EE;'>#坏死#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41432, encryptionId=b723414321c, topicName=坏死)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0e3195, createdName=millore, createdTime=Tue Jun 26 07:46:00 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=327026, encodeId=08f732e026f4, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Jun 26 01:30:31 CST 2018, time=2018-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326712, encodeId=80f7326e12ee, content=^_^^_^^_^^_^, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Swp2ehfHpiciczeTntUyQOlIGMzQ705ic67sdMTVMbwTv7KbmlUvxrGvRSvQZjPkz7ib5tEDfIaORgczPtmHDpwojg/0, createdBy=c54b2163125, createdName=wqkm, createdTime=Sun Jun 24 21:45:19 CST 2018, time=2018-06-24, status=1, ipAttribution=)]
    2018-06-24 wqkm

    ^_^^_^^_^^_^

    0

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