AJG: 免疫抑制药物治疗的炎症性肠病患者发生基底细胞癌的发生率显著增加

2020-08-08 MedSci原创 MedSci原创

关于炎症性肠病(IBD)患者中反复发生基底细胞癌(BCC)的情况临床中并不少见,尤其是持续使用免疫抑制药物后这种概率会明显增加。那么这样的相关性是否真实存在,还没有研究进行探究。

背景及目的:

关于炎症性肠病(IBD)患者中反复发生基底细胞癌(BCC)的情况临床中并不少见,尤其是持续使用免疫抑制药物后这种概率会明显增加。那么这样的相关性是否真实存在,还没有研究进行探究,本项研究旨在进行这方面的尝试。

方法:

研究人员对54919例IBD患者进行了回顾性队列研究。研究人员根据IBD药物的使用情况定义患者的暴露情况:(i)仅使用氨基水杨酸酯(5-ASA),(ii)仅使用硫代嘌呤(TP),(iii)过去TP使用(6个月前终止)且不使用抗肿瘤坏死因子(TNF),(iv)先前使用TP后使用抗TNF,(v)仅使用抗TNF,以及(vi)使用抗TNF和TP的活性。主要观察结局是反复发生BCC。使用95%置信区间的调整后和未调整风险比来估计重复BCC发生的风险。

结果:

本项研究显示共有518例患者发展为BCC。每100人年重复发生BCC的次数为12.8(仅适用于5-ASA),34.5(TP使用),19.3(过去TP使用且未使用抗TNF),25.4(先前TP后使用抗TNF)使用),17.8(仅使用抗TNF)和22.4(有效使用抗TNF和TP)。与单独使用5-ASA相比,仅主动使用TP会增加重复发生BCC的风险(调整后的危险比1.65,95%置信区间1.24-2.19;P = 0.0005)。但是,其他暴露类别不再存在增加的风险。

结论:

接受硫唑嘌呤药物治疗的IBD患者发生BCC事件的概率明显增加,而其他药物不会导致BCC发生的风险增加。

原始出处:

Khan, Nabeel. Et al. Repeated Occurrences of Basal Cell Cancer in Patients With Inflammatory Bowel Disease Treated With Immunosuppressive Medications. The American Journal of Gastroenterology.2020.

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    2020-08-08 暖玉生烟

    真好

    0

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