AP&T: 低剂量糖皮质激素也会导致自身免疫性肝炎发生不良事件

2019-11-28 不详 MedSci原创

自身免疫性肝炎需要长期治疗,全身性糖皮质激素是治疗管理的基础。长期使用皮质类固醇可能会导致不良事件,为了评估自身免疫性肝炎患者的长期维持治疗中与皮质类固醇剂量有关的不良事件,本项研究进行了相关探索。

背景
自身免疫性肝炎需要长期治疗,全身性糖皮质激素是治疗管理的基础。长期使用皮质类固醇可能会导致不良事件,为了评估自身免疫性肝炎患者的长期维持治疗中与皮质类固醇剂量有关的不良事件,本项研究进行了相关探索。

方法
研究人员回顾性收集了476例确诊为自身免疫性肝炎的患者(77%为女性)的数据。用广义估计方程进行二元逻辑回归分析,以分析目前使用皮质类固醇激素与自体免疫性肝炎诊断后白内障,糖尿病和骨折发病之间的关系。同时校正了性别,年龄,诊断时的肝硬化和前3年使用泼尼松的使用,以说明可能的影响。

结果
本项研究共记录了6634人年。所有诊断时的中位年龄为44岁(范围2-88)。在120(25%)位患者中记录到了不良事件的发生。低剂量泼尼松龙(0.1-5.0 mg / d)增加了骨折的几率,而高剂量(> 5.0 mg / d)增加了白内障和糖尿病的几率。布地奈德增加了白内障和骨折的几率;这种作用与在过去1、2或3年使用泼尼松龙无关。

结论
即使低剂量的皮质类固醇激素也经常导致严重的不良事件。

原始出处:
Floris F. van den Brand. Et al. Adverse events related to low dose corticosteroids in autoimmune hepatitis. Alimentary Pharmacology and Therapeutics. 2019.

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