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β受体阻滞剂、其他降压药物与银屑病之间的关联:基于人群的病例对照研究。

Association between beta-blockers, other antihypertensive drugs and psoriasis: population-based case-control study.

作者信息

Brauchli Y B, Jick S S, Curtin F, Meier C R

机构信息

Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacology and Toxicology, University Hospital Basel, 4031 Basel, Switzerland.

出版信息

Br J Dermatol. 2008 Jun;158(6):1299-307. doi: 10.1111/j.1365-2133.2008.08563.x. Epub 2008 Apr 10.

Abstract

BACKGROUND

Several case reports have associated use of beta-blockers with an increased risk of psoriasis or psoriasiform drug eruptions.

OBJECTIVES

To study the association between use of beta-blockers and other antihypertensive drugs and the risk of developing a first-time diagnosis of psoriasis.

METHODS

We conducted a case-control analysis on the U.K.-based General Practice Research Database. We identified cases with an incident psoriasis diagnosis between 1994 and 2005 and matched them to one control patient on age, sex, general practice, calendar time (same index date) and years of history in the database. Conditional logistic regression was used to estimate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of developing a first-time psoriasis diagnosis in relation to previous exposure to antihypertensive drugs, stratified by exposure timing (current vs. past use) and exposure duration based on the number of prescriptions.

RESULTS

The study encompassed 36 702 cases with a first-time psoriasis diagnosis and the same number of matched controls. Adjusted ORs for current use of 1-4, 5-19 or >or= 20 prescriptions for beta-blockers, as compared with nonuse, were 0.93 (95% CI 0.76-1.13), 1.10 (95% CI 0.97-1.24), and 1.10 (95% CI 1.01-1.20), respectively. The risk estimates for current use of other antihypertensives at any exposure duration were all close to 1.0.

CONCLUSIONS

This large population-based case-control analysis does not support the current proposition that beta-blocker use is associated with an increased risk of psoriasis, nor did we find evidence for a substantially altered psoriasis risk for other antihypertensive drugs.

摘要

背景

多项病例报告表明,使用β受体阻滞剂会增加患银屑病或银屑病样药疹的风险。

目的

研究使用β受体阻滞剂及其他抗高血压药物与首次诊断为银屑病的风险之间的关联。

方法

我们基于英国全科医学研究数据库进行了一项病例对照分析。我们确定了1994年至2005年间首次诊断为银屑病的病例,并将其与一名对照患者按年龄、性别、全科医疗、日历时间(相同索引日期)以及在数据库中的病史年限进行匹配。采用条件逻辑回归来估计与既往接触抗高血压药物相关的首次诊断为银屑病的调整比值比(OR)及95%置信区间(CI),并根据接触时间(当前使用与过去使用)和基于处方数量的接触持续时间进行分层。

结果

该研究纳入了36702例首次诊断为银屑病的病例以及相同数量的匹配对照。与未使用β受体阻滞剂相比,当前使用1 - 4张、5 - 19张或≥20张β受体阻滞剂处方的调整OR分别为0.93(95%CI 0.76 - 1.13)、1.10(95%CI 0.97 - 1.24)和1.10(95%CI 1.01 - 1.20)。在任何接触持续时间下,当前使用其他抗高血压药物的风险估计值均接近1.0。

结论

这项基于大规模人群的病例对照分析不支持目前关于使用β受体阻滞剂会增加银屑病风险的观点,我们也未发现其他抗高血压药物会显著改变银屑病风险的证据。

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