静脉血栓栓塞事件在接受抗 TNF 治疗的类风湿关节炎患者中并未增加：来自英国风湿病学会生物制剂登记处的结果。
Venous thrombotic events are not increased in patients with rheumatoid arthritis treated with anti-TNF therapy: results from the British Society for Rheumatology Biologics Register.
机构信息
Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK.
出版信息
Ann Rheum Dis. 2011 Oct;70(10):1831-4. doi: 10.1136/ard.2011.153536. Epub 2011 Jul 22.
OBJECTIVES
Past studies have reported conflicting rates of venous thrombotic events (VTEs) in rheumatoid arthritis (RA). The current study aimed to compare (1) the rates of VTEs in patients with RA treated with anti-tumour necrosis factor (anti-TNF) therapy versus those treated with non-biological disease-modifying antirheumatic drugs (nbDMARDs) alone and (2) the rates between each individual anti-TNF agent and nbDMARDs.
METHODS
Using data from the British Society for Rheumatology Biologics Register, a national prospective observational cohort study of biological safety in patients with RA, the authors compared the incidence of VTEs between 11 881 anti-TNF- and 3673 nbDMARD-treated patients. Analysis was limited to the first VTE per person. HRs were calculated using Cox modelling. Adjustment was made for potential confounders including surgery performed during follow-up.
RESULTS
A total of 196 first VTEs were reported (151 anti-TNF, 45 nbDMARD). Overall there was no difference in the rates of VTEs between anti-TNF- and nbDMARD-treated patients (adjusted HR 0.8 (95% CI 0.5 to 1.5)). The risk was similar across all anti-TNF agents. Rates of postoperative VTEs did not significantly differ between groups.
CONCLUSIONS
These data suggest that anti-TNF therapy is not associated with an increased risk of VTEs in RA patients.
目的
既往研究报告类风湿关节炎（RA）患者静脉血栓栓塞事件（VTE）的发生率存在差异。本研究旨在比较（1）接受抗肿瘤坏死因子（anti-TNF）治疗与单独接受非生物改善病情抗风湿药物（nbDMARDs）治疗的 RA 患者的 VTE 发生率，以及（2）每种 anti-TNF 药物与 nbDMARDs 之间的 VTE 发生率。
方法
作者利用英国风湿病学会生物制剂注册处的数据，这是一项针对 RA 患者生物安全性的全国前瞻性观察队列研究，比较了 11881 例接受 anti-TNF 和 3673 例接受 nbDMARD 治疗的患者的 VTE 发生率。分析仅限于每人的首次 VTE。使用 Cox 模型计算 HR。调整了潜在混杂因素，包括随访期间进行的手术。
结果
共报告了 196 例首次 VTE（151 例接受 anti-TNF 治疗，45 例接受 nbDMARD 治疗）。总体而言，anti-TNF 和 nbDMARD 治疗的患者 VTE 发生率无差异（调整 HR 0.8（95%CI 0.5 至 1.5））。所有 anti-TNF 药物的风险相似。两组术后 VTE 发生率无显著差异。
结论
这些数据表明，anti-TNF 治疗与 RA 患者 VTE 风险增加无关。
Zotero 插件