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Ann Rheum Dis：接受乌帕替尼治疗的类风湿性关节炎患者带状疱疹发病率和危险因素

2021-10-10 MedSci原创 MedSci原创

危险因素类风湿性关节炎乌帕替尼带状疱疹发病率
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UPA与ADA+MTX或MTX单药治疗相比，HZ发生率和事件发生率更高，而30mg与15mg剂量相比，HZ发生率和事件发生率更高。来自亚洲和既往有HZ病史的患者在接受UPA治疗时患HZ的风险可能会增加

乌帕替尼(UPA)是一种口服Janus激酶(JAK)抑制剂，被批准用于类风湿性关节炎(RA)治疗。JAK抑制剂与RA患者发生带状疱疹(HZ)的风险增加相关。

近日，风湿病领域顶级期刊Annals of the Rheumatic Diseases上发表了一篇研究文章，该研究旨在通过来自UPAIII期临床试验项目的接受UPA治疗的RA患者评估其HZ的发生率和危险因素。

在六项随机III期试验（数据截止日期为2020年6月30日）中，研究人员确定了接受UPA（单一疗法或联合疗法）的患者HZ暴露调整发生率/事件发生率。在接受甲氨蝶呤(MTX)单药治疗或阿达木单抗(ADA)+MTX治疗的患者中也确定了HZ发生率和事件率。多变量Cox回归分析用于确定UPA治疗患者HZ的危险因素。

本次分析共纳入了5306名患者。在MTX单药治疗组、ADA+MTX、15mg UPA和30mg UPA治疗组HZ的发生率分别为0.8人/100名患者每年(95%CI为0.3至1.9）、1.1（0.5至1.9）、3.0（2.6至3.5）和5.3（4.5至6.2）。大多数(71%)接受UPA治疗的HZ病例涉及单个皮节。HZ既往史和亚洲地区是UPA治疗患者发生HZ的危险因素。

由此可见，UPA与ADA+MTX或MTX单药治疗相比，HZ发生率和事件发生率更高，而30mg与15mg剂量相比，HZ发生率和事件发生率更高。来自亚洲和既往有HZ病史的患者在接受UPA治疗时患HZ的风险可能会增加。

原始出处：

Kevin L Winthrop,et al.Incidence and risk factors for herpes zoster in patients with rheumatoid arthritis receiving upadacitinib: a pooled analysis of six phase III clinical trials.Ann Rheum Dis.2021.https://ard.bmj.com/content/early/2021/10/06/annrheumdis-2021-220822

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    2022-07-07 cmj8wellington

    #Dis#

    0

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    2022-04-30 lifestar

    #发病率#

    0

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    2021-11-16 ms5000000753978789

    学习

    0

  4. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sun Oct 10 21:55:02 CST 2021, time=2021-10-10, status=1, ipAttribution=)]
    2021-10-12 lmm397

    #关节炎#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2013728, encodeId=9bca2013e281e, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Thu Jul 07 16:27:48 CST 2022, time=2022-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1823760, encodeId=e71d1823e60c3, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, 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beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sun Oct 10 21:55:02 CST 2021, time=2021-10-10, status=1, ipAttribution=)]
    2021-10-12 ms4964546379600229

    #类风湿#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2013728, encodeId=9bca2013e281e, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Thu Jul 07 16:27:48 CST 2022, time=2022-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1823760, encodeId=e71d1823e60c3, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, 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beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sun Oct 10 21:55:02 CST 2021, time=2021-10-10, status=1, ipAttribution=)]
    2021-10-12 wodejia-dayu

    #乌帕替尼#

    0

  7. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sun Oct 10 21:55:02 CST 2021, time=2021-10-10, status=1, ipAttribution=)]
    2021-10-12 ms1467340776200723

    #风湿性关节炎#

    0

  8. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sun Oct 10 21:55:02 CST 2021, time=2021-10-10, status=1, ipAttribution=)]
    2021-10-12 ms2694732865965676

    #疱疹#

    0

  9. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sun Oct 10 21:55:02 CST 2021, time=2021-10-10, status=1, ipAttribution=)]
    2021-10-11 学医无涯

    祸福相依

    0

  10. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sun Oct 10 21:55:02 CST 2021, time=2021-10-10, status=1, ipAttribution=)]
    2021-10-10 查查佳佳

    无咯饿不五杀了他妈滴绿咖啡机

    0

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大约20%的重症患者发生压力性损伤，ICU获得性压力性损伤与患者入院时病情严重程度以及ICU住院时间密切相关。

Hypertension：12至17岁青少年高血压的患病率和危险因素分析

根据两个指南对高血压的患病率进行了评估，其患病率相当高，其中包含几个危险因素，并且随访期间单次血压测量会高估青少年高血压患病率。

Eur Heart J：1型和2型心肌梗死危险因素比较！

与1型心肌梗死相关的冠心病危险因素也是2型事件的重要预测因子。治疗这些危险因素可能会降低1型和2型心肌梗死的风险。

Thyroid：缺铁是妊娠期甲状腺功能障碍的危险因素

缺铁，而且轻度缺碘，是孕妇血清FT4和T4的决定因素。除了预防妊娠期间的贫血外，纠正缺铁可能有助于维持最佳的甲状腺功能。