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Ann Rheum Dis:糖皮质激素在早期类风湿关节炎患者中的耐受性如何?

2017-11-28 门鹏 环球医学

2017年11月,发表于《Ann Rheum Dis》的ESPOIR试验数据,考察了糖皮质激素(GC)在早期类风湿关节炎(RA)患者中使用的7年耐受性特征。

2017年11月,发表于《Ann Rheum Dis》的ESPOIR试验数据,考察了糖皮质激素(GC)在早期类风湿关节炎(RA)患者中使用的7年耐受性特征。

目的:旨在探讨GC治疗早期RA的7年耐受性特征。

方法:研究者检测了ESPOIR队列(病程<6个月)中602例早期RA患者数据,并分为两组:随访期至少使用一次或不使用GC(中位随访7年(IQR,0.038~7.65))。主要结局为死亡、心血管疾病(包括心肌缺血、脑血管意外和心衰)、严重感染和骨折的复合。

结果:602例RA患者(476例女性(79%),平均48±12岁)中,386例(64.1%)GC治疗的患者接受了低剂量泼尼松(整个随访期平均3.1±2.9mg/d):263例在最初的6个月开始GC(68%),平均GC使用时间为1057±876天。与无GC患者(216人,35.9%)相比,GC患者使用非甾体抗炎药、合成和生物改善病情类抗类风湿药的人数较多,具有更积极的疾病致残性,较高的C反应蛋白和抗瓜氨酸蛋白抗体水平。65例事件(7例死亡,14例心血管疾病,19例感染,25例骨折)中,GC和无GC患者分别发生44例和21例(P=0.520)。虽不显着,但GC比无GC患者感染更频繁(P=0.09)。使用倾向得分和治疗加权逆概率并纳入了年龄、性别、高血压史和GC治疗的加权Cox成比例风险分析中,结局在GC和无GC患者中无差异(P=0.520;HR,0.889;95% CI,0.620~1.273)。

结论:这项ESPOIR队列的7年分析支持了低剂量GC治疗早期RA的良好安全性特征。

原始出处:
Roubille C, Rincheval N, Dougados M,et al.Seven-year tolerability profile of glucocorticoids use in early rheumatoid arthritis: data from the ESPOIR cohort.Ann Rheum Dis. 2017 Nov;76(11):1797-1802. doi: 10.1136/annrheumdis-2016-210135. Epub 2017 Feb 17.

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    2018-08-29 cmj8wellington
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topicName=皮质激素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cb1a18781011, createdName=bbwznl, createdTime=Thu Nov 30 05:20:00 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265475, encodeId=395c2654e584, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzR8ylhYfiaoAUx2BsaYHVia1IKhG3Cg8CT84rBrn6iaVRkyAibJxBcLEXabOQ5p19vWgDe34ib5ErxNgx/0, createdBy=8a701629084, createdName=jihuaijun1112, createdTime=Thu Nov 30 00:24:40 CST 2017, time=2017-11-30, status=1, ipAttribution=)]
    2017-12-01 jihuaijun1112

    学习学习学习

    0

  5. 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topicName=皮质激素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cb1a18781011, createdName=bbwznl, createdTime=Thu Nov 30 05:20:00 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265475, encodeId=395c2654e584, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzR8ylhYfiaoAUx2BsaYHVia1IKhG3Cg8CT84rBrn6iaVRkyAibJxBcLEXabOQ5p19vWgDe34ib5ErxNgx/0, createdBy=8a701629084, createdName=jihuaijun1112, createdTime=Thu Nov 30 00:24:40 CST 2017, time=2017-11-30, status=1, ipAttribution=)]
    2017-11-30 lmm397
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