Gastroenterology:英夫利昔单抗会增加IBD患儿的恶性肿瘤或噬血细胞综合征风险吗?

2017-06-29 门鹏 环球医学资讯

2017年6月,发表在《Gastroenterology》的一项由美国、意大利、荷兰等国科学家进行的研究表明,英夫利昔单抗(IFX)不增加炎症性肠病(IBD)患儿的恶性肿瘤或噬血细胞综合征(HLH)风险。

2017年,发表在《Gastroenterology》的一项由美国、意大利、荷兰等国科学家进行的研究表明,英夫利昔单抗(IFX)不增加炎症性肠病IBD)患儿的恶性肿瘤或噬血细胞综合征(HLH)风险。

背景和目的免疫抑制疗法治疗IBD儿童患者被认为增加了恶性肿瘤和淋巴增殖性疾病的风险,包括HLH。研究人员比较了暴露于IFX与没有暴露于IFX的IBD儿童患者中,患恶性肿瘤和HLH的未调整发生率,并计算了标准化发生率比(SIRs)。

方法:研究人员收集并分析来自2007年5月31日~2016年6月30日关于IBD患儿长期结局的前瞻性研究(NCT00606346)中的5766例患者数据。患者≤17岁、患有克罗恩病溃疡性结肠炎或未分类的IBD,随访时间为24543.0患者-年。研究人员评估恶性肿瘤和HLH的发生率,以事件/1000随访患者-年为单位。研究人员使用监管、流行病学和最终结果程序(SEER)数据库计算了年龄、性别和种族调整的SIRs,及95%置信区间(CIs)。

结果:发展为恶性肿瘤的13/15名患者和发展为HLH的全部5名患者全部暴露于巯嘌呤类药物;10名恶性肿瘤患者也暴露于生物制剂。未调整的发病率表明,暴露于IFX vs未暴露于IFX的患者中,恶性肿瘤(0.46/1000患者-年)或HLH(0.0/1000患者-年)的风险均未增加(恶性肿瘤:1.12/1000患者-年;HLH:0.56/1000患者-年)。SIRs没有显示暴露于IFX的患者(SIR,1.69;95% CI,0.46~4.32)vs未暴露的患者(SIR,2.17;95% CI,0.59~5.56)中恶性肿瘤的风险增加,甚至在病人经过巯基嘌呤暴露分层的情况下。

结论:使用来自大型临床研究和SEER数据库的数据,确定年龄、性别和种族调整的SIRs,研究人员发现,IBD儿童患者中IFX暴露与恶性肿瘤或HLH的风险增加不相关。巯基嘌呤暴露是IBD儿童患者中恶性肿瘤或HLH发展的一个重要的先例事件。

原始出处:

Rajiv A. Perinbasekar, Sara A. Brown, et al.Proactive Monitoring of Infliximab (IFX) and Adalimumab (ADA) Drug and Anti-Drug Antibody Concentration Utilizing the Labcorp Assay in Inflammatory Bowel Disease (IBD) Patients.Gastroenterology.April 2017Volume 152, Issue 5, Supplement 1, PageS392 .DOI: http://dx.doi.org/10.1016/S0016-5085(17)31549-4

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    2017-07-01 许安
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createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Jul 01 08:21:00 CST 2017, time=2017-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504304, encodeId=b58415043041c, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Sat Jul 01 08:21:00 CST 2017, time=2017-07-01, status=1, ipAttribution=)]
    2017-07-05 李东泽

    很好,不错,以后会多学习

    0

  6. 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createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Jul 01 08:21:00 CST 2017, time=2017-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504304, encodeId=b58415043041c, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Sat Jul 01 08:21:00 CST 2017, time=2017-07-01, status=1, ipAttribution=)]
    2017-07-02 hfuym10906

    学这首歌,,,

    0

  7. 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createdBy=e2dd327, createdName=许安, createdTime=Sat Jul 01 03:21:00 CST 2017, time=2017-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1681824, encodeId=98a8168182449, content=<a href='/topic/show?id=2fb489882cb' target=_blank style='color:#2F92EE;'>#血细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89882, encryptionId=2fb489882cb, topicName=血细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a79127868468, createdName=ailian1211, createdTime=Tue Nov 21 23:21:00 CST 2017, time=2017-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711100, encodeId=fba11e11100ca, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Mon Oct 02 06:21:00 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218783, encodeId=b4df218e839b, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Wed Jul 05 11:12:24 CST 2017, time=2017-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=217642, encodeId=aeae21e64204, content=学这首歌,,,, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuIjZYTAgkEia1SFuoeAByVaQC8uXegibpJEV2Q7SqhpDINJicNiaU5pYicYmy5WsI8l5hDribViac2A1BQ9/0, createdBy=c36f1724608, createdName=hfuym10906, createdTime=Sun Jul 02 06:00:19 CST 2017, time=2017-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1263439, encodeId=8810126343913, content=<a href='/topic/show?id=75bc930217' target=_blank style='color:#2F92EE;'>#IBD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9302, encryptionId=75bc930217, topicName=IBD)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc0372, createdName=bnurmamat, createdTime=Sat Jul 01 08:21:00 CST 2017, time=2017-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1283850, encodeId=cb641283850c4, content=<a href='/topic/show?id=886c4035e5d' target=_blank style='color:#2F92EE;'>#噬血细胞综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40357, encryptionId=886c4035e5d, topicName=噬血细胞综合征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Sat Jul 01 08:21:00 CST 2017, time=2017-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1430873, encodeId=faff14308e3e9, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Jul 01 08:21:00 CST 2017, time=2017-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504304, encodeId=b58415043041c, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Sat Jul 01 08:21:00 CST 2017, time=2017-07-01, status=1, ipAttribution=)]
    2017-07-01 bnurmamat
  8. [GetPortalCommentsPageByObjectIdResponse(id=2064148, encodeId=e7602064148a4, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Apr 26 00:21:00 CST 2018, time=2018-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071822, encodeId=f8a520e182274, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sat Jul 01 03:21:00 CST 2017, time=2017-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1681824, encodeId=98a8168182449, content=<a href='/topic/show?id=2fb489882cb' target=_blank style='color:#2F92EE;'>#血细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89882, encryptionId=2fb489882cb, topicName=血细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a79127868468, createdName=ailian1211, createdTime=Tue Nov 21 23:21:00 CST 2017, time=2017-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711100, encodeId=fba11e11100ca, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Mon Oct 02 06:21:00 CST 2017, time=2017-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218783, encodeId=b4df218e839b, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Wed Jul 05 11:12:24 CST 2017, time=2017-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=217642, encodeId=aeae21e64204, content=学这首歌,,,, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuIjZYTAgkEia1SFuoeAByVaQC8uXegibpJEV2Q7SqhpDINJicNiaU5pYicYmy5WsI8l5hDribViac2A1BQ9/0, createdBy=c36f1724608, createdName=hfuym10906, createdTime=Sun Jul 02 06:00:19 CST 2017, time=2017-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1263439, encodeId=8810126343913, content=<a href='/topic/show?id=75bc930217' target=_blank style='color:#2F92EE;'>#IBD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9302, encryptionId=75bc930217, topicName=IBD)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc0372, createdName=bnurmamat, createdTime=Sat Jul 01 08:21:00 CST 2017, time=2017-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1283850, encodeId=cb641283850c4, content=<a 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  9. 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  10. 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