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芦可替尼治疗骨髓纤维化患者的临床疗效:韩国一项基于全国人群的研究

Clinical Efficacy of Ruxolitinib in Patients with Myelofibrosis: A Nationwide Population-Based Study in Korea.

作者信息

Lee Byung-Hyun, Moon Hyemi, Chae Jae-Eun, Kang Ka-Won, Kim Byung-Soo, Lee Juneyoung, Park Yong

机构信息

Department of Internal Medicine, Korea University College of Medicine, Anam Hospital, Seoul 02841, Korea.

Department of Biostatistics, Korea University College of Medicine, Seoul 02841, Korea.

出版信息

J Clin Med. 2021 Oct 18;10(20):4774. doi: 10.3390/jcm10204774.

Abstract

Previous studies have reported the survival benefit after ruxolitinib treatment in patients with myelofibrosis (MF). However, population-based data of its efficacy are limited. We analyzed the effects of ruxolitinib in MF patients with data from the Korean National Health Insurance Database. In total, 1199 patients diagnosed with MF from January 2011 to December 2017 were identified, of which 731 were included in this study. Patients who received ruxolitinib ( = 224) were matched with those who did not receive the drug ( = 507) using the 1:1 greedy algorithm. Propensity scores were formulated using five variables: age, sex, previous history of arterial/venous thrombosis, and red blood cell (RBC) or platelet (PLT) transfusion dependence at the time of diagnosis. Cox regression analysis for overall survival (OS) revealed that ruxolitinib treatment (hazard ratio (HR), 0.67; = 0.017) was significantly related to superior survival. In the multivariable analysis for OS, older age (HR, 1.07; < 0.001), male sex (HR, 1.94; = 0.021), and RBC (HR, 3.72; < 0.001) or PLT (HR, 9.58; = 0.001) transfusion dependence were significantly associated with poor survival, although type of MF did not significantly affect survival. Considering evidence supporting these results remains weak, further studies on the efficacy of ruxolitinib in other populations are needed.

摘要

以往研究报道了芦可替尼治疗骨髓纤维化(MF)患者后的生存获益。然而,基于人群的疗效数据有限。我们利用韩国国民健康保险数据库的数据分析了芦可替尼对MF患者的影响。2011年1月至2017年12月期间,共识别出1199例诊断为MF的患者,其中731例纳入本研究。使用1:1贪婪算法将接受芦可替尼治疗的患者(n = 224)与未接受该药的患者(n = 507)进行匹配。利用五个变量制定倾向评分:年龄、性别、动脉/静脉血栓形成既往史以及诊断时红细胞(RBC)或血小板(PLT)输血依赖情况。对总生存期(OS)进行的Cox回归分析显示,芦可替尼治疗(风险比(HR),0.67;P = 0.017)与更好的生存显著相关。在OS的多变量分析中,年龄较大(HR,1.07;P < 0.001)、男性(HR,1.94;P = 0.021)以及RBC(HR,3.72;P < 0.001)或PLT(HR,9.58;P = 0.001)输血依赖与生存较差显著相关,尽管MF类型对生存没有显著影响。鉴于支持这些结果的证据仍然薄弱,需要对芦可替尼在其他人群中的疗效进行进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13f5/8540308/b9c729711f50/jcm-10-04774-g001.jpg

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Ruxolitinib for myelofibrosis.芦可替尼用于治疗骨髓纤维化。
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本文引用的文献

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Does ruxolitinib prolong the survival of patients with myelofibrosis?芦可替尼能否延长骨髓纤维化患者的生存期?
Blood. 2017 Feb 16;129(7):832-837. doi: 10.1182/blood-2016-11-731604. Epub 2016 Dec 28.

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