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Ann Rheum Dis:bDMARDs治疗RA患者的严重感染

2016-08-25 Moon 译 MedSci原创

这项观察性队列研究调查了生物性(b)疾病修饰治疗风湿病的药物(DMARDs)对类风湿关节炎患者严重感染(SIs)结局的影响。 研究调查了947例德国生物制剂登记RABBIT(类风湿性关节炎:生物治疗的观察)研究中发生SIs的患者。结果包括(1)恢复无并发症,(2)SI后出现脓毒症(≤30 天) ,(3)SI后死亡(没有已知脓毒症)。研究者对纵向数据使用了多项广义估计方程模型,同时评估败血症和

这项观察性队列研究调查了生物性(b)疾病修饰治疗风湿病的药物(DMARDs)对类风湿关节炎患者严重感染(SIs)结局的影响。

研究调查了947例德国生物制剂登记RABBIT(类风湿性关节炎:生物治疗的观察)研究中发生SIs的患者。结果包括(1)恢复无并发症,(2)SI后出现脓毒症(≤30 天) ,(3)SI后死亡(没有已知脓毒症)。研究者对纵向数据使用了多项广义估计方程模型,同时评估败血症和死亡的风险。

SI后30天内出现脓毒症的有135/947名患者,其中85名有致命结结果。53名SI后90天内死亡,但没有已知脓毒症记录。调整后的发展为脓毒症的风险随着年龄的增加而增加,并且慢性肾脏病患者风险更高。

与传统合成(cs)DMARDs相比,出现SI时使用bDMARDs有更低的风险(OR: 0.56, 95% CI 0.38 to 0.81)。致命性SI的危险因素包括年龄、使用高剂量糖皮质激素和心脏衰竭。使用bDMARDs治疗和更好的身体功能与死亡风险的下降有关。

这一结果表明bDMARDs对SI后死亡风险以及致命性结局风险的有效性。成功的免疫抑制可能会预防不受管制的针对SI的宿主反应,变成脓毒症。一步的调查是必要的,以验证这些结果。

原始出处:

Richter A, et al. Impact of treatment with biologic DMARDs on the risk of sepsis or mortality after serious infection in patients with rheumatoid arthritis .Ann Rheum Dis. 2016;doi:10.1136/annrheumdis-2015-207838.

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    2017-08-03 drwjr
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    2016-10-11 1e10c84am36(暂无匿称)

    好文章,受益

    0

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    2016-09-13 ylzr123

    赞一个!认真学习了。

    0

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    2016-08-27 whlxd
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  8. [GetPortalCommentsPageByObjectIdResponse(id=2040220, encodeId=9017204022036, content=<a href='/topic/show?id=cb0b1520365' target=_blank style='color:#2F92EE;'>#RDS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, 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 Aug 03 01:27:00 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2012121, encodeId=e98920121218c, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Wed Jun 21 12:27:00 CST 2017, time=2017-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145971, encodeId=8ce51459e1b3, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 22:29:47 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124459, encodeId=a32e124459f7, content=赞一个!认真学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Sep 13 10:21:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395311, encodeId=229313953115e, content=<a href='/topic/show?id=019a60434f' target=_blank style='color:#2F92EE;'>#DMARDs#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, 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=Sat Aug 27 14:27:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587607, encodeId=ad50158e60759, content=<a href='/topic/show?id=d6706042a3' target=_blank style='color:#2F92EE;'>#DMARD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, 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=Sat Aug 27 14:27:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1594223, encodeId=8b45159422343, content=<a href='/topic/show?id=c5c9211855f' target=_blank style='color:#2F92EE;'>#严重感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21185, encryptionId=c5c9211855f, topicName=严重感染)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Sat Aug 27 14:27:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1622022, encodeId=072a1622022cf, content=<a href='/topic/show?id=2587329570' target=_blank style='color:#2F92EE;'>#bDMARD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3295, encryptionId=2587329570, topicName=bDMARD)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Sat Aug 27 14:27:00 CST 2016, time=2016-08-27, status=1, ipAttribution=)]
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