Rheumatology:治疗幼年特发性关节炎患儿,TNF-α抑制剂vs DMARD

2018-03-02 吴星 环球医学

2018年2月,发表于《Rheumatology (Oxford)》上的一项研究,考察了与DMARD相比,TNF-α抑制剂(TNFI)的使用会为幼年特发性关节炎(JIA)患儿带来较高的严重感染风险。

2018年2月,发表于《Rheumatology (Oxford)》上的一项研究,考察了与DMARD相比,TNF-α抑制剂(TNFI)的使用会为幼年特发性关节炎(JIA)患儿带来较高的严重感染风险。

目的:黑框警告显示,基于成人研究的证据,TNFI会增加严重感染风险。然而,儿童中该相关性的证据缺乏。研究者旨在检测与DMARD相比,JIA患儿中,TNFI带来的感染风险。

方法:研究者使用2009~2013年的Truven市场扫描商业索赔记录与遇到的数据库进行了这项队列研究。研究者鉴别出初始TNFI或DMARD单一治疗的<16岁的JIA患儿,并对他们进行了需要住院的严重细菌感染的跟踪。Cox成比例风险模型用于评估与DMARD相比,TNFI相关感染的风险比,并使用高维倾向得分和时变CS调整了潜在混杂因素。

结果:研究者鉴别出2013例初始DMARD者和482例初始TNFI者,分别中位随访255和307天。研究者在DMARD和TNFI组分别鉴别出18和11例严重感染患者,分别造成1.28/100人年(95% CI,0.76~2.02)和2.72/100人年(95% CI,1.36~4.86)的粗发生率。调整模型中,与DMARD相比,TNFI与严重细菌感染风险的增加相关(调整风险比,2.72;95% CI,1.08~6.86)。

结论:与DMARD相比,TNFI的使用会为JIA患儿带来较高的严重感染风险。研究者的分析证实了美国食品药品监督管理局关于JIA儿童TNFI相关感染的警告。

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    2018-05-15 jklm09
  4. [GetPortalCommentsPageByObjectIdResponse(id=2062535, encodeId=a62420625351f, content=<a href='/topic/show?id=872c15438a4' target=_blank style='color:#2F92EE;'>#Rheumatology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15438, encryptionId=872c15438a4, topicName=Rheumatology)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3307462, createdName=风铃821, createdTime=Wed Jan 09 05:05:00 CST 2019, time=2019-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1894656, encodeId=731b189465647, content=<a href='/topic/show?id=e45b6e859f3' target=_blank style='color:#2F92EE;'>#特发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67859, encryptionId=e45b6e859f3, topicName=特发性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Wed May 09 01:05:00 CST 2018, time=2018-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1851658, encodeId=a859185165847, 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=34, 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=Tue May 15 16:05:00 CST 2018, time=2018-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294847, encodeId=9e8229484e9b, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Sat Mar 10 10:54:38 CST 2018, time=2018-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265638, encodeId=a787126563863, 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=24, 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=Sat Mar 03 23:05:00 CST 2018, time=2018-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401667, encodeId=fa2f140166e38, content=<a href='/topic/show?id=17e21e57943' target=_blank style='color:#2F92EE;'>#TNF#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17579, encryptionId=17e21e57943, topicName=TNF)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqjVbfRD4f4vibEcZVcvato8Qib1gGtZJiayXCMFgHrkeErSiaxdYMiabKGxY2an9muxWCkUJbjFPViaC6A/132, createdBy=e4fb2361580, createdName=snowpeakxu, createdTime=Sat Mar 03 23:05:00 CST 2018, time=2018-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1495825, encodeId=7d201495825f4, content=<a href='/topic/show?id=9df21e5833d' target=_blank style='color:#2F92EE;'>#TNF-α抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17583, encryptionId=9df21e5833d, topicName=TNF-α抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4fcb9213199, createdName=DEXTER3142, createdTime=Sat Mar 03 23:05:00 CST 2018, time=2018-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587611, encodeId=c8f3158e6119a, content=<a href='/topic/show?id=d6706042a3' target=_blank style='color:#2F92EE;'>#DMARD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6042, encryptionId=d6706042a3, topicName=DMARD)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=94e417527720, createdName=whlxd, createdTime=Sat Mar 03 23:05:00 CST 2018, time=2018-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=292233, encodeId=ca3a29223318, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Fri Mar 02 08:39:47 CST 2018, time=2018-03-02, status=1, ipAttribution=)]
    2018-03-10 owlhealth

    不错耶.学习了

    0

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    2018-03-03 lmm397
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    2018-03-03 snowpeakxu
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    2018-03-03 whlxd
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    2018-03-02 明月清辉

    谢谢分享.学习了

    0

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《玻璃酸钠在骨科和运动医学相关疾病中的应用专家共识(2017 年修订版)》解读

2017 年11 月,《玻璃酸钠在骨科和运动医学相关疾病中的应用专家共识(2017 年修订版)》正式发布,该共识对玻璃酸钠的来源、作用机制、药物代谢、安全性、不良反应、适应证、禁忌证等方面进行了全面修订,其中作用机制、适应证等内容修改幅度较大,更为适用和细化。本文就其重要更新内容进行简介和解读。