Semin Arthritis Rheu:类风湿性关节炎中与羟氯喹、甲氨蝶呤、生物制剂和糖皮质激素相关的糖尿病

2022-05-20 xiangting MedSci原创

在RA患者中,羟氯喹、甲氨蝶呤和TNFi与患糖尿病的风险降低相关,而糖皮质激素与糖尿病的风险升高相关。

这项研究旨在评估没有糖尿病的类风湿性关节炎(RA)患者中,疾病改善抗风湿药物对患糖尿病风险的影响。

对PubMed、EMBASE和Cochrane图书馆电子数据库以及会议记录分别进行检索和手工搜索,查找2019年10月以前发表的研究。纳入评估RA患者中糖尿病与抗风湿药物之间关联的队列研究或病例对照研究。根据I2采用固定效应或随机效应荟萃分析对数据进行汇总,并将汇总风险比(HRs)及其95%置信区间(CIs)作为汇总统计量。

共纳入15项研究,包括552,019例RA患者(羟氯喹11项,甲氨蝶呤7项,肿瘤坏死因子抑制剂[TNFi] 6项,糖皮质激素8项)。在汇总分析中,使用羟氯喹(meta-HR 0.61,95%CI 0.56-0.66)、甲氨蝶呤(meta-HR 0.81,95%CI 0.75-0.87)和TNFi(meta-HR 0.63,95%CI 0.55-0.71)与糖尿病风险降低相关,而糖皮质激素则以剂量依赖性方式增加了糖尿病的风险(任何剂量:meta-HR 1.46,95%CI 1.39-1.53​​;泼尼松龙<10mg/天或等效剂量:meta-HR 1.30,95%CI 1.13-1.51;泼尼松龙≥10mg/天或同等剂量:meta-HR 2.25,95%CI 1.88-2.70)。

在RA患者中,羟氯喹、甲氨蝶呤和TNFi与患糖尿病的风险降低相关,而糖皮质激素与糖尿病的风险升高相关。这些重要发现有助于RA治疗的临床决策。对于患糖尿病风险高的RA患者,需要进行大型前瞻性和设计良好的研究。

原始出处:

Wenhui Xie. Incident diabetes associated with hydroxychloroquine, methotrexate, biologics and glucocorticoids in rheumatoid arthritis: A systematic review and meta-analysis. Semin Arthritis Rheu. 16 May 2020.

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objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Fri May 22 04:07:18 CST 2020, time=2020-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334378, encodeId=4f3e13343e89f, 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=54, 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, createdName=ms4964546379600229, createdTime=Fri May 22 04:07:18 CST 2020, time=2020-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357920, encodeId=4e74135e92009, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri May 22 04:07:18 CST 2020, time=2020-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483764, encodeId=4c381483e64f7, 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=42, 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=Fri May 22 04:07:18 CST 2020, time=2020-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1600467, encodeId=395d160046ea6, content=<a href='/topic/show?id=3565e21649e' target=_blank style='color:#2F92EE;'>#皮质激素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72164, encryptionId=3565e21649e, topicName=皮质激素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cb1a18781011, createdName=bbwznl, createdTime=Fri May 22 04:07:18 CST 2020, time=2020-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043128, encodeId=cad2104312892, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Wed May 20 16:07:18 CST 2020, time=2020-05-20, status=1, ipAttribution=)]
    2020-05-22 lmm397
  5. [GetPortalCommentsPageByObjectIdResponse(id=1826044, encodeId=f2771826044c4, content=<a href='/topic/show?id=6191692233a' target=_blank style='color:#2F92EE;'>#生物制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69223, encryptionId=6191692233a, topicName=生物制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Fri Dec 18 06:07:18 CST 2020, time=2020-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1701330, encodeId=c9961e013304f, content=<a href='/topic/show?id=b5f6e6827fb' target=_blank style='color:#2F92EE;'>#糖皮质#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76827, encryptionId=b5f6e6827fb, topicName=糖皮质)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0f4230340116, createdName=Tommy1959, createdTime=Tue Nov 24 16:07:18 CST 2020, time=2020-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1972799, encodeId=6d4f19e2799b4, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Thu Feb 04 17:07:18 CST 2021, time=2021-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266460, encodeId=969c126646061, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Fri May 22 04:07:18 CST 2020, time=2020-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334378, encodeId=4f3e13343e89f, 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=54, 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, createdName=ms4964546379600229, createdTime=Fri May 22 04:07:18 CST 2020, time=2020-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357920, encodeId=4e74135e92009, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri May 22 04:07:18 CST 2020, time=2020-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483764, encodeId=4c381483e64f7, 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=42, 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=Fri May 22 04:07:18 CST 2020, time=2020-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1600467, encodeId=395d160046ea6, content=<a href='/topic/show?id=3565e21649e' target=_blank style='color:#2F92EE;'>#皮质激素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72164, encryptionId=3565e21649e, topicName=皮质激素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cb1a18781011, createdName=bbwznl, createdTime=Fri May 22 04:07:18 CST 2020, time=2020-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043128, encodeId=cad2104312892, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Wed May 20 16:07:18 CST 2020, time=2020-05-20, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1826044, encodeId=f2771826044c4, content=<a href='/topic/show?id=6191692233a' target=_blank style='color:#2F92EE;'>#生物制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69223, encryptionId=6191692233a, topicName=生物制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Fri Dec 18 06:07:18 CST 2020, time=2020-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1701330, encodeId=c9961e013304f, content=<a href='/topic/show?id=b5f6e6827fb' target=_blank style='color:#2F92EE;'>#糖皮质#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76827, encryptionId=b5f6e6827fb, topicName=糖皮质)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0f4230340116, 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04:07:18 CST 2020, time=2020-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357920, encodeId=4e74135e92009, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri May 22 04:07:18 CST 2020, time=2020-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483764, encodeId=4c381483e64f7, 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=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, 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authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Wed May 20 16:07:18 CST 2020, time=2020-05-20, status=1, ipAttribution=)]
    2020-05-22 zhaojie88
  7. 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  8. 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    2020-05-20 misszhang

    谢谢MedSci提供最新的资讯

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