Ann Rheum Dis:预防老年人肾病:别嘌醇vs非布司他

2017-10-13 吴星 环球医学

2017年10月,发表在《Ann Rheum Dis》的一项由美国科学家进行的Medicare索赔数据分析,比较了别嘌醇和非布司他预防老年人肾病的有效性。

2017年10月,发表在《Ann Rheum Dis》的一项由美国科学家进行的Medicare索赔数据分析,比较了别嘌醇和非布司他预防老年人肾病的有效性。

目的:评价别嘌醇和非布司他预防老年人肾病的有效性。

方法:在一项使用2006年至2012年Medicare索赔数据的回顾性队列研究中,研究者纳入新使用别嘌醇或非布司他(基线183天无两种药物中任何一种)的患者。研究者使用5:1倾向匹配Cox回归分析,比较别嘌醇使用(和剂量)与非布司他(参照)的肾病HR。敏感性分析包括校正多变量回归模型。

结果:26443例患者中,有31465例别嘌醇或非布司他新治疗;肾病中8570例治疗停止。别嘌醇组的肾病粗发生率为192/1000患者-年,非布司他组为338/1000患者-年。每日剂量较高,每1000患者-年肾病粗发生率较低:别嘌醇<200、200~299和≥300 mg/天的肾病粗发生率分别为238、176和155;非布司他40和80 mg/天的肾病粗发生率分别为341和326。在倾向匹配分析中,与非布司他相比,别嘌醇的使用与较低的肾病HR相关,0.61(95% CI 0.49~0.77)。与非布司他40?mg/天相比,别嘌醇剂量<200、200~299和≥300 mg/天与较低的肾病HR相关,分别为0.75(95% CI 0.65~0.86)、0.61(95% CI 0.52~0.73)和0.48(95% CI 0.41~0.55)。使用校正多变量回归的敏感性分析证实了这些结果。

结论:与非布司他相比,别嘌醇与老年患者较低的肾病风险相关。需要未来研究以考察别嘌醇潜在肾脏获益的机制。

原始出处:

Singh JA and Cleveland JD. Comparative effectiveness of allopurinol versus febuxostat for preventing incident renal disease in older adults: an analysis of Medicare claims data. Ann Rheum Dis. 2017 Oct;76(10):1669-1678. doi: 10.1136/annrheumdis-2017-211210. Epub 2017 Jun 5.

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    2017-10-13 hhh678

    henhao

    0

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    2017-10-13 changjiu

    学习了.谢谢

    0

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