Semin Arthritis Rheu:两种bDMARDs联合治疗类风湿性关节炎的安全性

2018-12-22 xiangting MedSci原创

这项研究结果表明,使用两种bDMARDs联合治疗RA似乎会增加治疗前12个月内的SAEs风险。

这项研究对现有文献进行了系统评价和meta分析,以评估两种生物性疾病改善抗风湿药物(bDMARDs)联合治疗类风湿性关节炎(RA)的安全性。

研究人员系统检索了评估与剂量方案无关两种bDMARDs治疗RA安全性的对照研究。使用的数据库是MEDLINE(通过Pubmed)、EMBase、Cochrane图书馆、Scopus、ClinicalTrials.gov和WHO国际临床试验注册平台。在联合治疗组和单一治疗组之间进行meta分析,使用随机效应模型计算比值比(OR)以及95%置信区间(CI)。主要结局是严重不良事件(SAEs)的发生率。

共纳入6项研究的623名患者(410名联合治疗,213名单一治疗)。中位随访时间为9.5个月(范围6-12个月)。联合治疗组的SAEs(14.9 vs 6.0%,OR 2.51,95%CI 1.29-4.89,I2 0%)和总不良事件显著增多(94.6 vs 89.1%,OR 2.07,95%CI 1.11-3.86,I2 0%)。对只接受两种bDMARDs全剂量治疗的患者进行亚组分析时,严重感染率显著升高(6.7 vs 0.6%,OR 5.58,95%CI 1.25-24.90,I2 0%),SAEs的风险仍显著升高(17.1 vs 6.2%,OR 2.72,95%CI 1.30-5.69,I2 0%)。

这项研究结果表明,使用两种bDMARDs联合治疗RA似乎会增加治疗前12个月内的SAEs风险。

原始出处:

Goncalo Boleto. Safety of combination therapy with two bDMARDs in patients with rheumatoid arthritis: a systematic review and meta-analysis. Semin Arthritis Rheu. 18 December 2018.

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    2019-10-03 drwjr
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    2018-12-24 lmm397
  4. 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  5. [GetPortalCommentsPageByObjectIdResponse(id=2040249, encodeId=31922040249fa, content=<a href='/topic/show?id=cb0b1520365' target=_blank style='color:#2F92EE;'>#RDS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15203, encryptionId=cb0b1520365, topicName=RDS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=08e964, createdName=drwjr, createdTime=Thu Oct 03 14:21:00 CST 2019, time=2019-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1972579, encodeId=aef519e257955, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, 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objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6042, encryptionId=d6706042a3, topicName=DMARD)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Mon Dec 24 02:21:00 CST 2018, time=2018-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1622031, encodeId=3f6a1622031ae, content=<a href='/topic/show?id=2587329570' target=_blank style='color:#2F92EE;'>#bDMARD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3295, encryptionId=2587329570, topicName=bDMARD)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Mon Dec 24 02:21:00 CST 2018, time=2018-12-24, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=2040249, encodeId=31922040249fa, content=<a href='/topic/show?id=cb0b1520365' target=_blank style='color:#2F92EE;'>#RDS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15203, encryptionId=cb0b1520365, topicName=RDS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=08e964, createdName=drwjr, createdTime=Thu Oct 03 14:21:00 CST 2019, time=2019-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1972579, encodeId=aef519e257955, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, 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style='color:#2F92EE;'>#联合治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80712, encryptionId=d4cc80e128f, topicName=联合治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=263b421, createdName=zhaozuguo, createdTime=Mon Dec 24 02:21:00 CST 2018, time=2018-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334099, encodeId=839e1334099cf, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, 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encryptionId=019a60434f, topicName=DMARDs)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b3ad2500191, createdName=12498dd9m11暂无昵称, createdTime=Mon Dec 24 02:21:00 CST 2018, time=2018-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483567, encodeId=8192148356eec, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Mon Dec 24 02:21:00 CST 2018, time=2018-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587622, encodeId=7659158e62212, content=<a href='/topic/show?id=d6706042a3' target=_blank style='color:#2F92EE;'>#DMARD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6042, encryptionId=d6706042a3, topicName=DMARD)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Mon Dec 24 02:21:00 CST 2018, time=2018-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1622031, encodeId=3f6a1622031ae, content=<a href='/topic/show?id=2587329570' target=_blank style='color:#2F92EE;'>#bDMARD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3295, encryptionId=2587329570, topicName=bDMARD)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Mon Dec 24 02:21:00 CST 2018, time=2018-12-24, status=1, ipAttribution=)]
    2018-12-24 zhaojie88
  7. 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