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降脂药物的使用与标准疗程治疗的结核病患者的转归改善无关:一项基于人群的队列研究。

Use of lipid-lowering agents is not associated with improved outcomes for tuberculosis patients on standard-course therapy: A population-based cohort study.

机构信息

Department of Medicine, Taipei City Hospital Heping Fuyou Branch, Taipei, Taiwan.

Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.

出版信息

PLoS One. 2019 Jan 11;14(1):e0210479. doi: 10.1371/journal.pone.0210479. eCollection 2019.

Abstract

OBJECTIVES

Animal and ex vitro studies suggested lipid-lowering agents (LLAs) may be used as an adjunct to standard anti- tuberculosis (TB) treatment. No human study has been conducted to date. Using the Taiwan National Health Insurance Research Database (NHIRD), the current population-based cohort study sought to examine the association between use of LLAs and outcomes of patients with pulmonary TB receiving anti-TB treatment.

METHODS

Using a NHIRD from 2003 to 2010, this population-based cohort study retrospectively examined the association between LLAs (statins or fibrates) and the outcomes of patients with pulmonary TB receiving anti-TB treatment.

RESULTS

A total of 1452 adult patients newly diagnosed with pulmonary TB during the study period were identified and compared with 5808 matched patients. In the LAA cohort, 1258 received statin, and 295 received fibrate. Compared with patients who did not take LLA, patients who took oral LLAs had similar incidence of treatment completion at 9, 12, and 24 months.

CONCLUSIONS

Neither statins nor fibrates provide clinical benefit superior to that achieved with standard anti-tuberculosis treatment. Future clinical trials should investigate the effects of statins and fibrates on short-course standard anti-TB therapy.

摘要

目的

动物和体外研究表明,降脂药(LLAs)可作为标准抗结核(TB)治疗的辅助药物。迄今为止,尚未进行人类研究。本基于人群的队列研究利用台湾全民健康保险研究数据库(NHIRD),旨在检验降脂药(他汀类或贝特类)的使用与接受抗结核治疗的肺结核患者结局之间的相关性。

方法

本基于人群的队列研究使用 2003 年至 2010 年的 NHIRD,回顾性检验了降脂药(他汀类或贝特类)与接受抗结核治疗的肺结核患者结局之间的相关性。

结果

研究期间共确定了 1452 例新诊断为肺结核的成年患者,并与 5808 例匹配患者进行了比较。在 LAA 队列中,1258 例接受了他汀类药物治疗,295 例接受了贝特类药物治疗。与未服用 LLA 的患者相比,服用口服 LLA 的患者在 9、12 和 24 个月时的治疗完成率相似。

结论

他汀类药物和贝特类药物均不能提供优于标准抗结核治疗的临床获益。未来的临床试验应研究他汀类药物和贝特类药物对短程标准抗 TB 治疗的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f662/6329498/642155d1efe8/pone.0210479.g001.jpg

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