ANN RHEUM DIS:羟氯喹对类风湿关节炎患者的代谢和心血管益处

2022-05-15 xiangting MedSci原创

除了对疾病活动性和进展的有限功效之外,HCQ可能有益于RA患者的代谢特征并减少心血管事件的程度。

血管疾病(CVD)是类风湿关节炎(RA)患者死亡的主要原因。羟氯喹(HCQ)已被证明可以提高其他炎性疾病的生存率。这项研究旨在评估HCQ对RA患者心血管影响的现有相关文献。

研究人员系统检索了有关评估HCQ对RA患者CVD已知危险因素心血管结局影响的研究。数据库为MEDLINE(通过PubMed)、EMBase、Cochrane图书馆和美国风湿病学会和欧洲抗风湿病联盟年会。使用随机效应模型进行荟萃分析,估计平均差异(MDs),HRs和95%CIs。数据由一名研究者提取,并由另一名研究者独立检查。

文献检索发现了185篇相关文章和摘要;进一步的检查发现16项符合标准的研究。HCQ使用者和非使用者的总体、低密度和高密度胆固醇及甘油三酯水平的MDs分别为-9.8(95%CI -14.0至-5.6),-10.6(95%CI -14.2至-7.0) ,+4.1(95%CI 2.2-6.0)和-19.2(95%CI -27.2--11.1)。HCQ使用者的糖尿病发病率低于非使用者(HR 0.59(95%CI 0.49-0.70))。HCQ降低了胰岛素抵抗和CVD的发生率,但数据太少不能进行荟萃分析。

除了对疾病活动性和进展的有限功效之外,HCQ可能有益于RA患者的代谢特征并减少心血管事件的程度,这表明其与其他常规疾病改善抗风湿药物联合使用时的有效性。

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    2017-10-17 lmm397
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