Clin J Am Soc Nephrol:羟氯喹如何影响类风湿性关节炎患者CKD风险?

2022-06-22 王淳 环球医学

2018年5月,发表在《Clin J Am Soc Nephrol》的一项由中国台湾学者进行的观察性队列研究,考察了新确诊为类风湿性关节炎(RA)的患者使用羟氯喹与慢性肾病(CKD)风险之间的相关性。

2018年5月,发表在《Clin J Am Soc Nephrol》的一项由中国台湾学者进行的观察性队列研究,考察了新确诊为类风湿性关节炎(RA)的患者使用羟氯喹与慢性肾病(CKD)风险之间的相关性。

背景和目的:羟氯喹广泛用于RA患者。然而,缺乏检测羟氯喹对RA患者肾病发生发展长期影响的大规模研究。研究旨在评估羟氯喹和该人群CKD风险之间的长期相关性。

设计、地点、参与者和测量:研究人员进行了一项观察性队列研究,研究对象为新确诊为RA的患者,这些患者于2000年1月1日~2013年12月31日前瞻性纳入到台湾全岛健康保险研究数据库中。研究人员使用多变量Cox成比例风险回归,分析了羟氯喹与CKD之间的相关性。

结果:总共纳入2619名患者,其中羟氯喹使用者1212人,不使用者1407人。48/1212名羟氯喹使用者和121/1407名不使用者发生CKD。羟氯喹使用者比不使用者的CKD发病率低(10.3 vs 13.8/1000人-年)。多变量调整后,羟氯喹使用者仍然比不使用者具有较低的CKD风险(调整风险比[HR],0.64;95%置信区间[CI],0.45~90;P=0.01)。随后较低的CKD发生风险是剂量依赖性的,并且各亚组分析结果都一致。

结论:与不使用者相比,新确诊为RA的患者使用羟氯喹与显著性低的CKD风险相关。

原始出处:

Wu CL, Chang CC, Kor CT, et.al. Hydroxychloroquine Use and Risk of CKD in Patients with Rheumatoid Arthritis. Clin J Am Soc Nephrol. 2018 May 7;13(5):702-709. doi: 10.2215/CJN.11781017. Epub 2018 Apr 16.

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