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接受白细胞介素 17 抑制剂治疗的银屑病患者新发炎症性肠病的真实世界风险。

Real-world risk of new-onset inflammatory bowel disease among patients with psoriasis exposed to interleukin 17 inhibitors.

机构信息

Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York.

Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York.

出版信息

J Am Acad Dermatol. 2020 Aug;83(2):382-387. doi: 10.1016/j.jaad.2020.04.010. Epub 2020 Apr 11.

Abstract

BACKGROUND

Information on the real-world risk of inflammatory bowel disease (IBD) among patients with psoriasis exposed to interleukin-17 inhibitor (IL-17i) is limited.

OBJECTIVE

To compare IBD risk in patients with psoriasis with and without IL-17i exposure.

METHODS

Retrospective cohort analysis of patients with psoriasis with and without IL-17i exposure identified by using electronic health records data. Primary outcomes were 6-month and 1-year IBD incidence.

RESULTS

Crude 6-month IBD incidence was 0.16% (3/1821) among patients with psoriasis exposed to any IL-17i, 0.24% (3/1246) among those exposed to secukinumab alone, and 0.11% (239/213,060) among those unexposed. Crude 1-year IBD incidence was 0.27% (5/1821) among IL-17i-exposed patients with psoriasis, 0.32% (4/1246) among those exposed to secukinumab alone, and 0.19% (412/213,060) among those unexposed. In adjusted analysis, there was no significant difference in odds of developing IBD at 6 months (odds ratio, 1.42; 95% confidence interval, 0.45-4.43) and 1 year (odds ratio, 1.37; 95% confidence interval, 0.57-3.33) between exposed and unexposed patients with psoriasis. Similarly, there was no significant difference in odds of developing IBD at 6 months and 1 year between secukinumab-exposed and -unexposed patients with psoriasis.

LIMITATIONS

Analysis may have been limited by the low number of outcome events.

CONCLUSION

The incidence of IBD among patients with psoriasis exposed to IL-17i is low, and the risk appears similar to that for unexposed patients with psoriasis.

摘要

背景

关于接受白细胞介素-17 抑制剂 (IL-17i) 治疗的银屑病患者发生炎症性肠病 (IBD) 的真实世界风险信息有限。

目的

比较有和无 IL-17i 暴露的银屑病患者发生 IBD 的风险。

方法

通过电子健康记录数据,对有和无 IL-17i 暴露的银屑病患者进行回顾性队列分析。主要结局为 6 个月和 1 年 IBD 发生率。

结果

在接受任何 IL-17i 治疗的银屑病患者中,6 个月时 IBD 的粗发生率为 0.16%(3/1821),单独接受司库奇尤单抗治疗的患者中为 0.24%(3/1246),未暴露的患者中为 0.11%(239/213060)。在接受 IL-17i 治疗的银屑病患者中,1 年时 IBD 的粗发生率为 0.27%(5/1821),单独接受司库奇尤单抗治疗的患者中为 0.32%(4/1246),未暴露的患者中为 0.19%(412/213060)。在调整分析中,暴露和未暴露的银屑病患者发生 IBD 的 6 个月(比值比,1.42;95%置信区间,0.45-4.43)和 1 年(比值比,1.37;95%置信区间,0.57-3.33)的比值无显著差异。同样,在接受和未接受司库奇尤单抗治疗的银屑病患者中,6 个月和 1 年发生 IBD 的比值也无显著差异。

局限性

分析可能受到结局事件数量较少的限制。

结论

接受 IL-17i 治疗的银屑病患者发生 IBD 的发生率较低,风险似乎与未暴露的银屑病患者相似。

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