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J Allergy Clin Immunol:Omalizumab可能增加哮喘患者心脑血管事件的发生

2016-10-29 MedSci MedSci原创

背景:EXCELS是美国食品和药物管理局评估Omalizumab治疗恶性肿瘤的长期安全性的观察性研究。目的:检查在EXCELS中,Omalizumab与心血管(CV)和脑血管事件(CBV)之间潜在的相关性。方法: 参与队列研究的患者(≥12岁),中度至重度过敏性哮喘≤5年,基线时予Omalizumab(n = 5007)或不予Omalizumab治疗(n = 2829)的患者。分析包括总体CV /

背景:EXCELS是美国食品和药物管理局评估Omalizumab治疗恶性肿瘤的长期安全性的观察性研究。

目的:检查在EXCELS中,Omalizumab与心血管(CV)和脑血管事件(CBV)之间潜在的相关性。

方法:参与队列研究的患者(≥12岁),中度至重度过敏性哮喘≤5年,基线时予Omalizumab(n = 5007)或不予Omalizumab治疗(n = 2829)的患者。分析包括总体CV / CBV事件,主要集中在动脉血栓栓塞事件(ATE),包括心血管死亡、心肌梗死、缺血性卒中、短暂性脑缺血发作,或不稳定型心绞痛。校正潜在混杂因素,对ATE相关终点进行预先设定分析。一个盲的独立专家小组裁定所有的事件。

结果:基线时,两组人口统计特征相似,但Omalizumab治疗组,严重的哮喘更为普遍(50% vs 23%)。Omalizumab治疗的患者有较高的CV/CBV严重不良事件发生率(13.4/1000人年[PY] vs  8.1/1000 PY)。Omalizumab治疗组ATE的发生率每1000PY为6.66(101例/ 15160PY),非Omalizumab治疗组为4.64(46例/ 9904PY)。有效控制混杂因素后,风险比为1.32(95% CI,0.91-1.91)。

结论:这项观察性研究结果表明Omalizumab治疗组CV / CBV事件的发生率较高。虽然哮喘的严重程度之间的差异可能导致了这种不平衡,但也不能排除增加事件发生的风险。

临床意义:目前哮喘管理指南不应受到影响。然而,健康专家应该意识到Omalizumab可能与严重的心脑血管事件相关联。

原始出处:

Iribarren C, Rahmaoui A, et al. Cardiovascular and cerebrovascular events among patients receiving omalizumab: Results from EXCELS, a prospective cohort study of moderate-to-severe asthma. J Allergy Clin Immunol. 2016 Sep 14.


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    2017-01-24 snf701207
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    2016-10-31 膀胱癌
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