Weng Meng-Tzu, Tung Chien-Chih, Chang Yuan-Ting, Leong Yew-Loong, Wang Yu-Ting, Wong Jau-Min, Wei Shu-Chen
Departments of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan.
Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei 220, Taiwan.
J Clin Med. 2018 Oct 27;7(11):394. doi: 10.3390/jcm7110394.
No nationwide, long-term follow-up study has assessed medication-associated outcomes for Asian patients with inflammatory bowel disease (IBD). This study examined medication-associated outcomes for Taiwanese patients with IBD.
In this nationwide cohort study, 3806 patients who had received catastrophic illness registration for IBD from 2001 to 2015 were enrolled.
A higher accumulated dosage of 5-aminosalicylic acid (5-ASA) was associated with decreased risks of hospitalization (hazard ratio (HR) = 0.6) and operation (HR = 0.5). Thiopurine was associated with increased risks of hospitalization (HR = 2.1 in the high-dosage group) and tuberculosis (TB; HR = 3.6) reactivation but not with operation risk. A higher accumulated dosage of anti-TNF-α agents was associated with increased risks of hospitalization (HR = 3.3), operation (HR = 2.9), hepatitis B (HR = 4.3), and TB (HR = 5.1) reactivation. Corticosteroids were associated with increased risks of hospitalization (HR = 3.5 in the high-dosage group), risk of operation, hepatitis B (HR = 2.8) and TB (HR = 2.8) reactivation.
5-ASA usage is associated with decreased risks of hospitalization and operation for patients with IBD, whereas thiopurine, corticosteroids, and anti-TNF-α agents are associated with increased risks of hospitalization and hepatitis B and TB reactivation.
尚无全国性的长期随访研究评估亚洲炎症性肠病(IBD)患者的药物相关结局。本研究调查了台湾IBD患者的药物相关结局。
在这项全国性队列研究中,纳入了2001年至2015年期间因IBD进行重大疾病登记的3806例患者。
较高累积剂量的5-氨基水杨酸(5-ASA)与住院风险降低(风险比(HR)=0.6)和手术风险降低(HR = 0.5)相关。硫唑嘌呤与住院风险增加(高剂量组HR = 2.1)和结核病(TB;HR = 3.6)复发相关,但与手术风险无关。较高累积剂量的抗TNF-α药物与住院风险增加(HR = 3.3)、手术风险增加(HR = 2.9)、乙型肝炎(HR = 4.3)和TB(HR = 5.1)复发相关。皮质类固醇与住院风险增加(高剂量组HR = 3.5)、手术风险、乙型肝炎(HR = 2.8)和TB(HR = 2.8)复发相关。
5-ASA的使用与IBD患者住院和手术风险降低相关,而硫唑嘌呤、皮质类固醇和抗TNF-α药物与住院风险增加以及乙型肝炎和TB复发相关。