Ann Rheum Dis:使用生物性DMARDs治疗的类风湿性关节炎患者继发性恶性肿瘤和死亡的风险

2017-12-10 xiangting MedSci原创

对于有癌症病史的RA患者,bDMARDs治疗与SMN风险升高无关。

这项研究旨在探讨在有原发性癌症病史并使用生物性疾病改善抗风湿药物(bDMARD)治疗的类风湿性关节炎(RA)患者中,继发性恶性肿瘤(SMN)和死亡的风险。 

2000 -2011年期间在DANBIO登记的RA患者(n = 15 286)中,根据丹麦癌症登记有1678例患有原发性癌症。计算了SMN和死亡的HRs。

随访期间,279例RA患者在其原发性癌症诊断前使用bDMARDs,220例仅癌症诊断后使用,92例在癌症诊断前后均有使用,而1203例RA患者不使用bDMARDs。与不使用bDMARDs相比(癌症部位调整后),使用bDMARDs与出现SMN的HR为1.11(95%CI 0.74-1.67)相关。在原发性癌症诊断前使用bDMARDs的死亡HR 增加1.53(95%CI 1.13-2.09 )。在进一步调整原发癌的范围之后,癌症前使用bDMARDs的死亡HR为1.20(95%CI 0.88-1.63),仅癌症后使用HR为1.36(95%CI 0.78-2.39),癌症前后均使用HR为1.22(95%CI 0.70-2.13)。

对于有癌症病史的RA患者,bDMARDs治疗与SMN风险升高无关。关于使用bDMARDs治疗的RA患者的死亡率没有明确结论。

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    2018-06-21 xzw113
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    2018-07-26 drwjr
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  4. 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createdName=drwjr, createdTime=Thu Jul 26 16:07:00 CST 2018, time=2018-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2012504, encodeId=d45c20125047d, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Sat Jul 21 02:07:00 CST 2018, time=2018-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1724449, encodeId=a3e81e24449fc, content=<a href='/topic/show?id=78ece8958b2' target=_blank style='color:#2F92EE;'>#继发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78958, encryptionId=78ece8958b2, topicName=继发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=499d33645837, createdName=feifers, createdTime=Wed Aug 15 14:07:00 CST 2018, time=2018-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265592, encodeId=a9a812655928a, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Dec 12 06:07:00 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333957, encodeId=0c2d133395e81, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Tue Dec 12 06:07:00 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395312, encodeId=2c311395312ae, content=<a href='/topic/show?id=019a60434f' target=_blank style='color:#2F92EE;'>#DMARDs#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6043, encryptionId=019a60434f, topicName=DMARDs)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b3ad2500191, createdName=12498dd9m11暂无昵称, createdTime=Tue Dec 12 06:07:00 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483453, encodeId=c993148345313, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Tue Dec 12 06:07:00 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587609, encodeId=77a0158e609d4, content=<a href='/topic/show?id=d6706042a3' target=_blank style='color:#2F92EE;'>#DMARD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6042, encryptionId=d6706042a3, topicName=DMARD)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=94e417527720, createdName=whlxd, createdTime=Tue Dec 12 06:07:00 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268599, encodeId=d39226859901, content=学习了.涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Mon Dec 11 13:21:22 CST 2017, time=2017-12-11, status=1, ipAttribution=)]
    2018-08-15 feifers
  5. [GetPortalCommentsPageByObjectIdResponse(id=1952659, encodeId=0c63195265928, content=<a href='/topic/show?id=a37ce8961a1' target=_blank style='color:#2F92EE;'>#继发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78961, encryptionId=a37ce8961a1, topicName=继发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2317301, createdName=xzw113, createdTime=Thu Jun 21 20:07:00 CST 2018, time=2018-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2040234, encodeId=ab3920402345d, content=<a href='/topic/show?id=cb0b1520365' target=_blank style='color:#2F92EE;'>#RDS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15203, encryptionId=cb0b1520365, topicName=RDS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=08e964, createdName=drwjr, createdTime=Thu Jul 26 16:07:00 CST 2018, time=2018-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2012504, encodeId=d45c20125047d, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Sat Jul 21 02:07:00 CST 2018, time=2018-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1724449, encodeId=a3e81e24449fc, content=<a href='/topic/show?id=78ece8958b2' target=_blank style='color:#2F92EE;'>#继发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78958, encryptionId=78ece8958b2, topicName=继发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=499d33645837, createdName=feifers, createdTime=Wed Aug 15 14:07:00 CST 2018, time=2018-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265592, encodeId=a9a812655928a, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Dec 12 06:07:00 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333957, encodeId=0c2d133395e81, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Tue Dec 12 06:07:00 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395312, encodeId=2c311395312ae, content=<a href='/topic/show?id=019a60434f' target=_blank style='color:#2F92EE;'>#DMARDs#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6043, encryptionId=019a60434f, topicName=DMARDs)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b3ad2500191, createdName=12498dd9m11暂无昵称, createdTime=Tue Dec 12 06:07:00 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483453, encodeId=c993148345313, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Tue Dec 12 06:07:00 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587609, encodeId=77a0158e609d4, content=<a href='/topic/show?id=d6706042a3' target=_blank style='color:#2F92EE;'>#DMARD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6042, encryptionId=d6706042a3, topicName=DMARD)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=94e417527720, createdName=whlxd, createdTime=Tue Dec 12 06:07:00 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268599, encodeId=d39226859901, content=学习了.涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Mon Dec 11 13:21:22 CST 2017, time=2017-12-11, status=1, ipAttribution=)]
    2017-12-12 lmm397
  6. [GetPortalCommentsPageByObjectIdResponse(id=1952659, encodeId=0c63195265928, content=<a href='/topic/show?id=a37ce8961a1' target=_blank style='color:#2F92EE;'>#继发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78961, encryptionId=a37ce8961a1, topicName=继发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2317301, createdName=xzw113, createdTime=Thu Jun 21 20:07:00 CST 2018, time=2018-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2040234, encodeId=ab3920402345d, content=<a href='/topic/show?id=cb0b1520365' target=_blank style='color:#2F92EE;'>#RDS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15203, encryptionId=cb0b1520365, topicName=RDS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=08e964, 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level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Tue Dec 12 06:07:00 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395312, encodeId=2c311395312ae, content=<a href='/topic/show?id=019a60434f' target=_blank style='color:#2F92EE;'>#DMARDs#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6043, encryptionId=019a60434f, topicName=DMARDs)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b3ad2500191, createdName=12498dd9m11暂无昵称, createdTime=Tue Dec 12 06:07:00 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483453, encodeId=c993148345313, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Tue Dec 12 06:07:00 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587609, encodeId=77a0158e609d4, content=<a href='/topic/show?id=d6706042a3' target=_blank style='color:#2F92EE;'>#DMARD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6042, encryptionId=d6706042a3, topicName=DMARD)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=94e417527720, createdName=whlxd, createdTime=Tue Dec 12 06:07:00 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268599, encodeId=d39226859901, content=学习了.涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Mon Dec 11 13:21:22 CST 2017, time=2017-12-11, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1952659, encodeId=0c63195265928, content=<a href='/topic/show?id=a37ce8961a1' target=_blank style='color:#2F92EE;'>#继发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78961, encryptionId=a37ce8961a1, topicName=继发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2317301, createdName=xzw113, createdTime=Thu Jun 21 20:07:00 CST 2018, time=2018-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2040234, encodeId=ab3920402345d, content=<a href='/topic/show?id=cb0b1520365' target=_blank style='color:#2F92EE;'>#RDS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15203, encryptionId=cb0b1520365, topicName=RDS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=08e964, 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  8. 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time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483453, encodeId=c993148345313, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Tue Dec 12 06:07:00 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587609, encodeId=77a0158e609d4, content=<a href='/topic/show?id=d6706042a3' target=_blank style='color:#2F92EE;'>#DMARD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6042, encryptionId=d6706042a3, topicName=DMARD)], attachment=null, 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  9. 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time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483453, encodeId=c993148345313, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Tue Dec 12 06:07:00 CST 2017, time=2017-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587609, encodeId=77a0158e609d4, content=<a href='/topic/show?id=d6706042a3' target=_blank style='color:#2F92EE;'>#DMARD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6042, encryptionId=d6706042a3, topicName=DMARD)], attachment=null, 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    2017-12-12 whlxd
  10. 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    2017-12-11 1ddf0692m34(暂无匿称)

    学习了.涨知识

    0

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Ann Rheum Dis:炎症性风湿疾病的恐惧评估问卷(FAIR)

尽管疾病控制良好,17.2%的患者恐惧评分高。高恐惧分数与心理困扰有关。

NEJM:金丝针治疗类风湿性关节炎-病例报道

在东亚和全球,针灸,包括金线针刺疗法,长期以来一直被用来治疗关节疼痛。有时也使用口服和注射黄金制剂。在初步诊断类风湿性关节炎后,该患者接受甲氨蝶呤和来氟米特的联合治疗。当她被转诊至研究人员所在医院,研究者改变了她的治疗方案采用甲氨蝶呤和阿巴西普联合治疗,而且为该患者进行了足部畸形手术,关节疼痛大幅减轻。

《2017年意大利共识指南:类风湿性关节炎患者HBV感染的管理》摘译

意大利风湿病学学会(SIR)联合意大利传染病和热带疾病研究学会(SIMIT)共同发布了类风湿性关节炎患者乙肝病毒感染的管理指南,HBV感染是许多国家最主要的公共健康问题,本文主要针对类风湿性关节炎患者HBV感染的管理提供共识建议。

Arthritis Rheumatol:颌骨骨丧失与类风湿性关节炎的发作有关

本研究旨在探究牙周炎是否出现在RA症状出现之前。此外,我们分析了与对照组相比,在症状前个体中核因子κ-B(RANKL)(一种对骨吸收重要的细胞因子)和抗瓜氨酸肽抗体(ACPA)的受体激活剂的血浆水平。 通过前磨牙/磨牙区域的颌骨X线片测量了176名受试者(其中93名已经发展为RA)的边缘颌骨水平。其中46人记录了症状发作前的X线片,性别、年龄和吸烟状态指标相匹配的有45个。使用ELISA分析血浆R

Ann Rheum Dis:来氟米特在怀孕期间的使用和不良妊娠结局的风险

妊娠期间母体来氟米特暴露与MCMs、早产、LBW或自然流产的风险显著升高无相关性。