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Ann Rheum Dis:类风湿性关节炎患者同时使用糖皮质激素和质子泵抑制剂的骨折风险

2020-12-16 xaingting MedSci原创

同时口服GC和PPI与骨质疏松性骨折的风险之间有相互作用。当RA患者同时口服GC和PPI时,应注意评估其骨折风险。

口服糖皮质激素(GC)和质子泵抑制剂(PPI)均可引起骨质疏松性骨折,而类风湿关节炎(RA)患者经常同时使用这两种药物,因此,这项研究探讨RA患者同时口服GCsPPI与骨质疏松性骨折风险之间的关系。

这是一项队列研究,纳入了1997年至2017年临床实践研究数据链50岁以上RA的患者。根据药物使用情况:目前使用(<6个月)最近使用(7-12个月)和既往使用(> 1年);以及每日剂量和累计剂量使用时间进行分层。通过时间相关的Cox比例风险模型对骨质疏松性骨折的风险进行评估,并根据生活方式合并症和合并用药情况进行了调整。

结果如下:在12 351例RA患者中(平均年龄68岁,女性占69%),发生了1411例骨质疏松性骨折。与不使用这两种药物相比,目前同时口服GCPPI与骨质疏松性骨折的风险升高1.6相关(调整后HR:1.60,95%CI:1.35-1.89)。而单独口服GCPPI引起骨质疏松性骨折风险仅升高1.2,两者有统计学差异。多数骨折部位与同时口服GC和PPI显著相关。骨折风险并着PPI剂量增加使用时间延长升高

同时口服GCPPI骨质疏松性骨折的风险之间有相互作用。当RA患者同时口服GCPPI时,应注意评估骨折风险。

原始出处:

Shahab Abtahi. Concomitant use of oral glucocorticoids and proton pump inhibitors and risk of osteoporotic fractures among patients with rheumatoid arthritis: a population-based cohort study. Ann Rheum Dis. December 2020.

 

 

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01:37:13 CST 2020, time=2020-12-17, status=1, ipAttribution=)]
    2022-02-25 屋顶瞄爱赏月

    学习了

    0

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    2021-09-02 云舒

    补钙重要性

    0

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objectType=article, channel=null, level=null, likeNumber=67, 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=Thu Dec 17 01:37:13 CST 2020, time=2020-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334273, encodeId=b57c13342e3c1, 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=92, 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=Thu Dec 17 01:37:13 CST 2020, time=2020-12-17, status=1, ipAttribution=)]
    2021-08-27 长岛冰茶茶

    可以

    0

  4. 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encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Tue Mar 16 09:37:13 CST 2021, time=2021-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1701296, encodeId=67a31e012961e, content=<a href='/topic/show?id=b5f6e6827fb' target=_blank style='color:#2F92EE;'>#糖皮质#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76827, encryptionId=b5f6e6827fb, topicName=糖皮质)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0f4230340116, createdName=Tommy1959, createdTime=Fri Jul 23 20:37:13 CST 2021, time=2021-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266256, encodeId=21951266256fe, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, 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01:37:13 CST 2020, time=2020-12-17, status=1, ipAttribution=)]
    2020-12-15 zhaojie88

    #类风湿性关节炎#患者同时使用#糖皮质激素##质子泵抑制剂##骨折#风险,这是以前没有详细考虑过的

    1

    展开1条回复
  5. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1011947, encodeId=9230101194e91, content=可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210206/a9e09ef6cd9142b19c5ee36e576e375e/9cc77e7a48024185980d36c36eafa2f7.jpg, createdBy=d2245450055, createdName=长岛冰茶茶, createdTime=Fri Aug 27 09:32:14 CST 2021, time=2021-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=908135, encodeId=37e89081351f, content=<a href='/topic/show?id=7face61750b' target=_blank style='color:#2F92EE;'>#类风湿性关节炎#</a>患者同时使用<a href='/topic/show?id=62d2e6828cc' target=_blank style='color:#2F92EE;'>#糖皮质激素#</a>和<a href='/topic/show?id=02f99235e23' target=_blank style='color:#2F92EE;'>#质子泵抑制剂#</a>的<a href='/topic/show?id=3c531016e571' target=_blank style='color:#2F92EE;'>#骨折#</a>风险,这是以前没有详细考虑过的, 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encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Tue Mar 16 09:37:13 CST 2021, time=2021-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1701296, encodeId=67a31e012961e, content=<a href='/topic/show?id=b5f6e6827fb' target=_blank style='color:#2F92EE;'>#糖皮质#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76827, encryptionId=b5f6e6827fb, topicName=糖皮质)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0f4230340116, createdName=Tommy1959, createdTime=Fri Jul 23 20:37:13 CST 2021, time=2021-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266256, encodeId=21951266256fe, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, 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01:37:13 CST 2020, time=2020-12-17, status=1, ipAttribution=)]
    2021-04-12 zhaojie88
  6. 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encryptionId=03ab923565b, topicName=质子泵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=761326143554, createdName=shenxlcyp, createdTime=Tue Mar 16 09:37:13 CST 2021, time=2021-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1701296, encodeId=67a31e012961e, content=<a href='/topic/show?id=b5f6e6827fb' target=_blank style='color:#2F92EE;'>#糖皮质#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76827, encryptionId=b5f6e6827fb, topicName=糖皮质)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0f4230340116, createdName=Tommy1959, createdTime=Fri Jul 23 20:37:13 CST 2021, time=2021-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266256, encodeId=21951266256fe, 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=67, 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=Thu Dec 17 01:37:13 CST 2020, time=2020-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334273, encodeId=b57c13342e3c1, 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=92, 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=Thu Dec 17 01:37:13 CST 2020, time=2020-12-17, status=1, ipAttribution=)]
    2021-10-13 jklm09
  7. 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  8. 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  9. 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    2020-12-17 lmm397
  10. 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