Ann Rheum Dis:风湿病生物制剂使用者中的结核

2019-12-04 xiangting MedSci原创

重新激活和新发结核是南非所有生物制剂使用者面临的一项重大风险。筛查LTBI是一项必要的预防措施。

这项研究旨在评估南非风湿病生物制剂使用者中的结核病率(TB),以及潜伏性TB感染LTBI)项目的有效性、危险因素和结局。

结核病病例来自南非生物制剂登记(SABIO)、风湿病医师和制药公司。记录人口学、LTBI筛查和治疗、生物性疾病改善抗风湿药物(DMARD)治疗、结核病诊断和结局。

1999年到20176月,共收集了96TB病例:类风湿性关节炎55例、强直性脊柱炎27例、银屑病关节炎4例和青少年炎性关节炎10例。生物制剂使用者(n = 96)的结核病率为1240/10万人年,而非生物制剂使用队列为0/10万人年,发病率差异为0.0124p<0.0001)。96TB60例患肺结核,36例患肺外结核。45例出现再激活结核。南非所有获得许可的生物制剂都出现了结核病例,与依那西普(861/10万人年)和非肿瘤坏死因子(TNF)抑制剂(681/10万人年)相比,大多数病例使用单克隆抑制剂(1683/10万人年)。与依那西普相比,单克隆抑制剂的发病率比是1.96p=0.005)。与非TNF抑制剂相比,单克隆抑制剂的发病率比是2.47p=0.002),非TNF抑制剂与依那西普之间无显著差异(p=0.336)。LTBI筛查阳性患者中(12.9%),14例出现结核,而大多数患者(77例)LTBI筛查阴性。统计学危险因素是黑人、男性、年龄小和在西开普省居住。出现了2例耐药结核病例和6例死亡。

重新激活和新发结核是南非所有生物制剂使用者面临的一项重大风险。筛查LTBI是一项必要的预防措施。

原始出处:

Clive Pettipher. Tuberculosis in biologic users for rheumatic diseases: results from the South African Biologics Registry (SABIO). Ann Rheum Dis. 02 December 2019.

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    2021-06-12 Morris

    必须要预防必须要预防

    0

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