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Rheumatology:治疗幼年特发性关节炎患儿,TNF-α抑制剂vs DMARD

2018-03-02 吴星 环球医学

2018年2月,发表于《Rheumatology (Oxford)》上的一项研究,考察了与DMARD相比,TNF-α抑制剂(TNFI)的使用会为幼年特发性关节炎(JIA)患儿带来较高的严重感染风险。

2018年2月,发表于《Rheumatology (Oxford)》上的一项研究,考察了与DMARD相比,TNF-α抑制剂(TNFI)的使用会为幼年特发性关节炎(JIA)患儿带来较高的严重感染风险。

目的:黑框警告显示,基于成人研究的证据,TNFI会增加严重感染风险。然而,儿童中该相关性的证据缺乏。研究者旨在检测与DMARD相比,JIA患儿中,TNFI带来的感染风险。

方法:研究者使用2009~2013年的Truven市场扫描商业索赔记录与遇到的数据库进行了这项队列研究。研究者鉴别出初始TNFI或DMARD单一治疗的<16岁的JIA患儿,并对他们进行了需要住院的严重细菌感染的跟踪。Cox成比例风险模型用于评估与DMARD相比,TNFI相关感染的风险比,并使用高维倾向得分和时变CS调整了潜在混杂因素。

结果:研究者鉴别出2013例初始DMARD者和482例初始TNFI者,分别中位随访255和307天。研究者在DMARD和TNFI组分别鉴别出18和11例严重感染患者,分别造成1.28/100人年(95% CI,0.76~2.02)和2.72/100人年(95% CI,1.36~4.86)的粗发生率。调整模型中,与DMARD相比,TNFI与严重细菌感染风险的增加相关(调整风险比,2.72;95% CI,1.08~6.86)。

结论:与DMARD相比,TNFI的使用会为JIA患儿带来较高的严重感染风险。研究者的分析证实了美国食品药品监督管理局关于JIA儿童TNFI相关感染的警告。

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    2018-05-15 jklm09
  4. [GetPortalCommentsPageByObjectIdResponse(id=2062535, encodeId=a62420625351f, content=<a href='/topic/show?id=872c15438a4' target=_blank style='color:#2F92EE;'>#Rheumatology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15438, encryptionId=872c15438a4, topicName=Rheumatology)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3307462, createdName=风铃821, createdTime=Wed Jan 09 05:05:00 CST 2019, time=2019-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1894656, encodeId=731b189465647, content=<a href='/topic/show?id=e45b6e859f3' target=_blank style='color:#2F92EE;'>#特发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67859, encryptionId=e45b6e859f3, topicName=特发性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Wed May 09 01:05:00 CST 2018, time=2018-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1851658, encodeId=a859185165847, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Tue May 15 16:05:00 CST 2018, time=2018-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294847, encodeId=9e8229484e9b, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Sat Mar 10 10:54:38 CST 2018, time=2018-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265638, encodeId=a787126563863, 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=54, 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=Sat Mar 03 23:05:00 CST 2018, time=2018-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401667, encodeId=fa2f140166e38, content=<a href='/topic/show?id=17e21e57943' target=_blank style='color:#2F92EE;'>#TNF#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17579, encryptionId=17e21e57943, topicName=TNF)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqjVbfRD4f4vibEcZVcvato8Qib1gGtZJiayXCMFgHrkeErSiaxdYMiabKGxY2an9muxWCkUJbjFPViaC6A/132, createdBy=e4fb2361580, createdName=snowpeakxu, createdTime=Sat Mar 03 23:05:00 CST 2018, time=2018-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1495825, encodeId=7d201495825f4, content=<a href='/topic/show?id=9df21e5833d' target=_blank style='color:#2F92EE;'>#TNF-α抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17583, encryptionId=9df21e5833d, topicName=TNF-α抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4fcb9213199, createdName=DEXTER3142, createdTime=Sat Mar 03 23:05:00 CST 2018, time=2018-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587611, encodeId=c8f3158e6119a, content=<a href='/topic/show?id=d6706042a3' target=_blank style='color:#2F92EE;'>#DMARD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, 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 Mar 03 23:05:00 CST 2018, time=2018-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=292233, encodeId=ca3a29223318, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Fri Mar 02 08:39:47 CST 2018, time=2018-03-02, status=1, ipAttribution=)]
    2018-03-10 owlhealth

    不错耶.学习了

    0

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    2018-03-03 lmm397
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    2018-03-03 snowpeakxu
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    2018-03-03 whlxd
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    2018-03-02 明月清辉

    谢谢分享.学习了

    0

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为规范玻璃酸钠(hyaluronan,HA)在骨科和运动医学相关疾病治疗中的合理应用,为临床医生提供较为翔实、准确、实用的HA 临床应用指导意见,人民卫生出版社《中国医学前沿杂志(电子版)》编辑部曾先后于2010 年1 月9 日和2012 年9 月16 日组织并邀请了全国数十位知名骨科和运动医学专家在北京召开了“玻璃酸钠在骨科中的应用专家研讨会” 和“玻璃酸钠在骨关节炎治疗中的应用专家共识研讨会”

关节炎是冻出来的?

大多数骨关节炎都与关节达到使用寿命有关,一些自身免疫性关节炎则是由于免疫系统紊乱而攻击自身关节组织所致

痛风增加化脓性关节炎风险

美国哈佛医学院麻省总医院风湿科的Sian Yik Lim和波士顿大学医学院的Na Lu、Hyon K. Choi在英国普通人群中开展的一项回顾性队列研究显示,成年人中的痛风会增加化脓性关节炎发病风险。

《玻璃酸钠在骨科和运动医学相关疾病中的应用专家共识(2017 年修订版)》解读

2017 年11 月,《玻璃酸钠在骨科和运动医学相关疾病中的应用专家共识(2017 年修订版)》正式发布,该共识对玻璃酸钠的来源、作用机制、药物代谢、安全性、不良反应、适应证、禁忌证等方面进行了全面修订,其中作用机制、适应证等内容修改幅度较大,更为适用和细化。本文就其重要更新内容进行简介和解读。

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