Rheumatology:系统性红斑狼疮怀孕女性的药物使用情况

2017-05-10 贾朝娟 环球医学

系统性红斑狼疮(SLE)疾病本身并不影响女性患者的生育能力,但病情活动需要用药。2017年4月,发表在《Rheumatology (Oxford)》的一项研究显示,在近一半的SLE孕妇中,女性被处方DMARDs和CSs。目的:本研究旨在描述怀孕前、孕期和孕后的SLE患者用药趋势,并比较SLE怀孕和未怀孕女性其他常见药物的使用。方法:从瑞典医学出生注册库(2006~2012)中识别出妊娠结局为活产或

系统性红斑狼疮(SLE)疾病本身并不影响女性患者的生育能力,但病情活动需要用药。2017年4月,发表在《Rheumatology (Oxford)》的一项研究显示,在近一半的SLE孕妇中,女性被处方DMARDs和CSs。

目的:本研究旨在描述怀孕前、孕期和孕后的SLE患者用药趋势,并比较SLE怀孕和未怀孕女性其他常见药物的使用。

方法:从瑞典医学出生注册库(2006~2012)中识别出妊娠结局为活产或死胎的女性。采用全国注册库识别出怀孕期有和没有SLE的女性,并且识别出孕前3个月至产后6个月的药物处方。研究者报道了SLE孕妇中DMARDs、系统性CSs和NSAIDs的流行率(单独报道阿司匹林)。研究者计算了怀孕期内处方给≥5%的SLE孕妇的其他药物的流行估算值,以及无SLE孕妇的相同药物。

结果:SLE女性中有483名孕妇,无SLE女性中有5723名孕妇。在SLE孕妇中,49.3%在怀孕期内使用1种或以上的DMARDs,CSs的使用率是48.0%,阿司匹林是40.8%,其他NSAIDs是6.0%,并且在不同怀孕期内是不同的。SLE孕妇中常用药物的使用率比无SLE孕妇高1.2至20倍;例如,达肝素(20.9 vs 1.0%),对乙酰氨基酚(18.2 vs 2.9%)和左甲状腺素(15.9 vs 4.9%)。

结论:在近一半的SLE孕妇中,女性被处方DMARDs和CSs。SLE孕妇中常用药物的流行估算值远高于无SLE孕妇。目前仍需要研究常用药物对SLE孕妇、母乳和后代长期结局的益处和风险。

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    2017-05-12 zhouqu_8

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ANN RHEUM DIS:系统性红斑狼疮的卒中情况—一项基于瑞典人群的队列研究

SLE患者缺血性卒中的相对风险是一般人群的两倍以上,重要的是在SLE诊断后第一年内相对风险最高。

Arthritis Rheumatol:皮下注射贝利木单抗治疗系统性红斑狼疮中的疗效和安全性

在中至重度SLE患者中,每周SC贝利木单抗200mg加标准SLE治疗,与安慰剂相比,显著改善其SRI4反应,降低了严重的疾病发作,并具有类似于安慰剂加标准SLE治疗的安全性。