2021ACR:别嘌醇和苯溴马隆治疗痛风患者的心血管风险

2021-11-16 MedSci原创 MedSci原创

结果无显著性差异。

虽然有不少研究探讨过降尿酸治疗对痛风患者血管风险影响,但很少有研究聚焦在“比较别嘌醇与苯溴马隆对痛风患者心血管风险影响区别”。为此,有韩国学者对此进行了探索,并将相关结果在ACR大会上进行分享。

研究方法

研究者通过使用韩国的健康保险审查和评估服务(HIRA)数据库,查找2009年-2015年间接受过别嘌醇或苯溴马隆治疗的18岁及以上的痛风患者。

纳入人群:别嘌醇组257097人,苯溴马隆组 7868人(平均年龄54.4岁,86%位男性)。

排除标准:研究者排除了在指标日期(接受别嘌醇或苯溴马隆开始治疗的日期)之前已接受过其他降尿酸药物或透析治疗1年的患者,同时,在研究期间,接受过别嘌醇和苯溴马隆以外的降尿酸或联合使用这两种药物的患者也在排除标准之内。

研究终点:该研究的主要研究终点是复合心血管终点的发生,包括冠状动脉血运重建、MI住院、缺血性脑卒中和TIA(短暂性脑缺血发作)。

研究结果

两组的复合CV终点的调整风险比(aHR)为1.01(95% CI 0.83-。121)没有显著性差异,两组在复合心血管终点和因心力衰竭住院的每个项目中均未发现显著性差异,在心血管疾病高危患者的亚组分析中,两组之间也没有显著性差异。然而,在分析仅限于服用别嘌醇>200mg和苯溴马隆≥50mg组时,主要结局无差异,但苯溴马隆组的冠脉血运重建风险更高(aHR 1.58,95%CI 1.16-2.14)。

 

参考来源:

Yeonghee Eun,et al.Cardiovascular Risk Associated with Treatment of Allopurinol and Benzbromarone in Patients with Gout.ACR Convergence 2021

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    2022-03-24 医路前行4231

    学习了

    0

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    2021-11-20 裸机丫

    0

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    2021-11-18 xugumin
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    2021-11-18 10518094zz
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    2021-11-16 柳~

    加油

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2082573, encodeId=10a820825e344, content=<a href='/topic/show?id=56658981223' target=_blank style='color:#2F92EE;'>#血管风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89812, encryptionId=56658981223, topicName=血管风险)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Thu Oct 27 11:23:12 CST 2022, time=2022-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1205496, encodeId=a9051205496af, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q3auHgzwzM6tia9pyZiaPziaeLHadUZP17uiav8DTro6peFy5lvuO5EjYrG4ButKWVynGX1CUFFBbXhib9bjE77pkHw/132, createdBy=41785253089, createdName=医路前行4231, createdTime=Thu Mar 24 10:07:52 CST 2022, time=2022-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1072304, encodeId=5ff910e230431, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=191, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=817d1712924, createdName=裸机丫, createdTime=Sat Nov 20 18:45:46 CST 2021, time=2021-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279628, encodeId=170912e962800, content=<a href='/topic/show?id=28b73234215' target=_blank style='color:#2F92EE;'>#别嘌醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32342, encryptionId=28b73234215, topicName=别嘌醇)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Thu Nov 18 08:23:12 CST 2021, time=2021-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1295129, encodeId=b2791295129f8, content=<a href='/topic/show?id=f1a68e07003' target=_blank style='color:#2F92EE;'>#苯溴马隆#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87070, encryptionId=f1a68e07003, topicName=苯溴马隆)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cc52251, createdName=yhy100200, createdTime=Thu Nov 18 08:23:12 CST 2021, time=2021-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1400504, encodeId=1d711400504b5, content=<a href='/topic/show?id=e7c018e7af' target=_blank style='color:#2F92EE;'>#ACR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1877, encryptionId=e7c018e7af, topicName=ACR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19792261142, createdName=10518094zz, createdTime=Thu Nov 18 08:23:12 CST 2021, time=2021-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1070838, encodeId=538f10e083810, content=加油, beContent=null, objectType=article, channel=null, level=null, likeNumber=193, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fed75610460, createdName=柳~, createdTime=Tue Nov 16 18:22:06 CST 2021, time=2021-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1070836, encodeId=289f10e0836ea, content=加油, beContent=null, objectType=article, channel=null, level=null, likeNumber=189, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fed75610460, createdName=柳~, createdTime=Tue Nov 16 18:18:26 CST 2021, time=2021-11-16, status=1, ipAttribution=)]
    2021-11-16 柳~

    加油

    0

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痛风与血尿酸升高密切相关。目前国际上广泛使用的降尿酸药物主要有抑制尿酸合成的别嘌醇、非布司他及促尿酸排泄药,主要是丙磺舒或苯溴马隆。别嘌醇因其有效性(疗效确切)及经济性(价格便宜)在全世界被广泛使用,成为降尿酸的一线用药。但临床应用时下列问题患者应加以注意,否则可能引起痛风发作或者发生药物不良反应。

ACR:接受别嘌醇初始治疗的患者发生SCARs的风险升高

SCARs常发生于别嘌醇初始用药后的180天里 别嘌醇是一种黄嘌呤氧化酶抑制剂,具有抑制尿酸生成的作用。约2-5%的患者可能对别嘌醇存在过敏反应,表现为皮疹或胃肠道症状。与别嘌醇使用相关的皮肤副反应很罕见,但可能威胁生命。目前研究中,以人口学为基础,对这些药物反应的发生率及死亡率的研究报道较少。为明确这类严重副作用的发生率和死亡率,来自波士顿布利甘-妇女医院的SEOYOUNG C. KIM博士等