Li Lin, Hagberg Katrina Wilcox, Peng Michael, Shah Kamal, Paris Maria, Jick Susan
From the *Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, MA; and †Celgene Corporation, Berkeley Heights, NJ.
J Clin Rheumatol. 2015 Dec;21(8):405-10. doi: 10.1097/RHU.0000000000000306.
Few studies report estimates of cardiovascular disease (CVD) or major adverse cardiovascular events (MACE) in patients with psoriatic arthritis (PsA).
To estimate rates of incident CVD and MACE in patients with PsA compared to patients without PsA.
Using the Clinical Practice Research Datalink, we conducted 2 cohort studies of patients with PsA compared to patients without PsA or psoriasis matched on age, sex, general practice, and calendar time: 1 study of CVD and 1 study of MACE. In each study, we excluded patients who had a study outcome before cohort entry. Cases were patients with a first-time diagnosis of CVD or MACE recorded during follow-up. We estimated incidence rates (IRs) and incidence rate ratios (IRRs) with 95% confidence intervals (95% CI) and stratified results in the PsA cohort by exposure to systemic PsA treatments.
The IR of CVD was higher in the patients with PsA compared to those without PsA (12.8/1000 person-years [PYs] [95% CI, 11.9-13.7] and 9.6/1000 PYs [95% CI, 9.3-9.0]; IRR, 1.33 [95% CI, 1.23-1.44]). The IR of MACE was slightly higher in the PsA compared to the non-PsA cohort (4.6/1000 PYs [95% CI, 4.1-5.1] and 3.5/1000 PYs [95% CI, 3.4-3.7]; IRR, 1.30 [95% CI, 1.15-1.47]). Among the patients with PsA, IRs were higher for those who received PsA treatments for both outcomes but did not differ significantly by type of treatment received.
The rates of CVD and MACE were slightly higher in the patients with PsA compared to the patients without PsA. Among the patients with PsA, rates of both outcomes were higher among those who received prescriptions for systemic PsA treatments.
很少有研究报告银屑病关节炎(PsA)患者的心血管疾病(CVD)或主要不良心血管事件(MACE)的估计值。
估计PsA患者与非PsA患者相比发生CVD和MACE的发生率。
利用临床实践研究数据链,我们对PsA患者与年龄、性别、全科医疗和日历时间相匹配的非PsA或银屑病患者进行了两项队列研究:一项关于CVD的研究和一项关于MACE的研究。在每项研究中,我们排除了在队列进入之前就有研究结局的患者。病例是在随访期间首次诊断为CVD或MACE的患者。我们估计了发病率(IRs)和发病率比(IRRs)及其95%置信区间(95%CI),并根据PsA队列中接受系统性PsA治疗的情况对结果进行分层。
与非PsA患者相比,PsA患者的CVD发病率更高(12.8/1000人年[PYs][95%CI,11.9 - 13.7]和9.6/1000 PYs[95%CI,9.3 - 9.0];IRR,1.33[95%CI,1.23 - 1.44])。与非PsA队列相比,PsA队列中MACE的发病率略高(4.6/1000 PYs[95%CI,4.1 - 5.1]和3.5/1000 PYs[95%CI,3.4 - 3.7];IRR,1.30[95%CI,1.15 - 1.47])。在PsA患者中,接受PsA治疗的患者这两种结局的发病率更高,但不同治疗类型之间无显著差异。
与非PsA患者相比,PsA患者的CVD和MACE发生率略高。在PsA患者中,接受系统性PsA治疗处方的患者这两种结局的发生率更高。