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Ann Rheum Dis:接受生物治疗的类风湿性关节炎患者的严重感染情况

2018-03-29 xiangting MedSci原创

初步分析中,培化舍珠单抗的SI发病率低于依那西普,但在多项敏感性分析中结果不再显著,这提示残余混杂可能解释观察到的差异。

这项研究旨在比较使用生物制剂治疗类风湿性关节炎(RA)严重感染(SI)的发病率,数据来自英国风湿病学会类风湿性关节炎生物制剂登记(BSRBR-RA)。

BSRBR-RA是一项前瞻性、观察性、队列研究。这项分析纳入开始使用1种新生物制剂的RA患者。主要结局是SI,SI定义为需要住院治疗,静脉注射抗生素或导致死亡的感染事件。计算事件发生率并使用Cox比例风险分析,在对可能的混杂因素调整后,比较不同的生物制剂。次要结局是感染后器官分类感染率和30天死亡率。

这项分析包括19 282例患者,随访46 771人年。整个队列的SI发病率为每100人年5.51例(95%CI为5.29至5.71)。与依那西普相比,完全调整后的模型中托珠单抗的SI风险更高(HR 1.22,95%CI 1.02至1.47),培化舍珠单抗的风险更低(HR 0.75,95%CI 0.58至0.97)。SI后的30天死亡率为10.4%(95%CI 9.2%至11.6%)。

初步分析中,培化舍珠单抗的SI发病率低于依那西普,但在多项敏感性分析中结果不再显著,这提示残余混杂可能解释观察到的差异。从这些结果来看,认为培化舍珠单抗比其他生物制剂的SI发病率更低是错误的;然而,风险也并没有像以前观察的那样更高。

原始出处:

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    2018-03-31 lmm397
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    2018-03-29 1ddf0692m34(暂无匿称)

    学习了.长知识

    0

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    2018-03-29 sunfeifeiyang

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    2018-03-29 医者仁心5538

    学习了

    0

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