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韩国和日本类风湿关节炎患者使用依那西普或阿达木单抗后严重不良事件的发生率及危险因素比较。

A comparison of incidence and risk factors for serious adverse events in rheumatoid arthritis patients with etanercept or adalimumab in Korea and Japan.

作者信息

Cho Soo-Kyung, Sakai Ryoko, Nanki Toshihiro, Koike Ryuji, Watanabe Kaori, Yamazaki Hayato, Nagasawa Hayato, Tanaka Yoshiya, Nakajima Atsuo, Yasuda Shinsuke, Ihata Atsushi, Ezawa Kazuhiko, Won Soyoung, Choi Chan-Bum, Sung Yoon-Kyoung, Kim Tae-Hwan, Jun Jae-Bum, Yoo Dae-Hyun, Miyasaka Nobuyuki, Bae Sang-Cheol, Harigai Masayoshi

机构信息

Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo , Japan.

出版信息

Mod Rheumatol. 2014 Jul;24(4):572-9. doi: 10.3109/14397595.2013.860695. Epub 2013 Dec 9.

Abstract

OBJECTIVE

To compare the incidence and risk factors of serious adverse events (SAEs) in rheumatoid arthritis (RA) patients treated with etanercept (ETN) or adalimumab (ADA) between Korean and Japanese registries.

METHODS

We recruited 416 RA patients [505.2 patient-years (PYs)] who started ETN or ADA from Korean registry and 537 RA patients (762.0 PY) from Japanese registry. The patient background, incidence rate (IR) of SAE in 2 years, and risk factors for SAEs were compared.

RESULTS

Korean patients were younger and used more nonbiologic DMARDs, higher doses of methotrexate, and lower doses of prednisolone (PSL). The IR of SAEs (/100 PY) was higher in the Japanese registry compared to the Korean [13.65 vs. 6.73]. In both registries, infection was the most frequently reported SAE. The only significant risk factor for SAEs in Korean registry was age by decade [1.45]. In Japanese registry, age by decade [1.54], previous use of nonbiologic DMARDs ≥ 4 [1.93], and concomitant use of oral PSL ≥ 5 mg/day [2.20] were identified as risk factors for SAEs.

CONCLUSIONS

The IR of SAE in Japan, especially infection, was higher than that of Korea, which was attributed to the difference of demographic and clinical characteristics of RA patients and treatment profiles.

摘要

目的

比较韩国和日本登记处中接受依那西普(ETN)或阿达木单抗(ADA)治疗的类风湿关节炎(RA)患者严重不良事件(SAE)的发生率及危险因素。

方法

我们从韩国登记处招募了416例开始使用ETN或ADA的RA患者[505.2患者年(PYs)],并从日本登记处招募了537例RA患者(762.0 PY)。比较了患者背景、2年SAE发生率(IR)及SAE的危险因素。

结果

韩国患者更年轻,使用更多非生物性改善病情抗风湿药(DMARDs)、更高剂量的甲氨蝶呤及更低剂量的泼尼松龙(PSL)。与韩国登记处相比,日本登记处SAEs的IR(/100 PY)更高[13.65对6.73]。在两个登记处中,感染是报告最频繁的SAE。韩国登记处中SAEs唯一显著的危险因素是按十年计算的年龄[1.45]。在日本登记处,按十年计算的年龄[1.54]、既往使用非生物性DMARDs≥4种[1.93]以及同时使用口服PSL≥5 mg/天[2.20]被确定为SAEs的危险因素。

结论

日本SAE的IR,尤其是感染的IR高于韩国,这归因于RA患者的人口统计学和临床特征及治疗情况的差异。

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