J Rheumatol:老年发病类风湿性关节炎患者使用甲氨蝶呤与心血管事件风险的关联

2018-12-07 xiangting MedSci原创

这项研究发现,最近连续使用MTX与CVE下降约20%相关。

这项研究评估了类风湿性关节炎(RA)患者时变性甲氨蝶呤(MTX)使用与血管事件(CVE)风险之间的关联。

对65岁生日后诊断为RA的23,994名患者的初始队列进行了研究。控制其他风险因素后,使用多因素Cox回归模型评估时变性MTX使用与出现CVE时间的相关性。替代模型评估了(1)第1年,(2)前一年(最近使用)和(3)整个随访期间使用MTX的累积持续时间。还评估了相关性的强度是否随时间变化。

在115,453患者年(PY)期间,3294名患者(13.7%)出现了CVE(每1000 PY 28.5事件;95%CI 27.6-29.5)。在多因素分析中,评估最近1年时变性连续用药模型的拟合性最佳。最近使用MTX增多与CVE风险较低相关(过去12个月连续使用vs不使用 HR为0.79,95%CI为0.70-0.88;p<0.0001)。进入队列后第1年使用MTX较多也是保护性的(HR 0.84,95%CI 0.72-0.96; p=0.0048),但这种效应随着随访的增加而降低。相反,整个随访期间使用MTX的时间较长与CVE风险没有显著相关性(HR 0.98,95%CI 0.95-1.01; p=0.1441)。

这项研究发现,最近连续使用MTX与CVE下降约20%相关。进入队列第1年使用MTX较多在MTX与CVE风险的相关性中也很重要。

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    2018-12-09 lmm397
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