质子泵抑制剂对免疫治疗中胃肠道免疫相关不良事件发生的影响。
Impact of proton pump inhibitors on the onset of gastrointestinal immune-related adverse events during immunotherapy.
机构信息
Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Biostatistics and Clinical Trial Center, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
出版信息
Cancer Med. 2023 Oct;12(19):19530-19536. doi: 10.1002/cam4.6565. Epub 2023 Sep 22.
INTRODUCTION
The gut microbiota (GM) can influence the pathogenesis of immune-mediated adverse events (irAEs). Proton pump inhibitors (PPIs) can affect the integrity of GM, but their role in promoting irAEs is still poorly understood.
METHODS
In this retrospective single-center cohort study, the primary endpoint was the evaluation of the incidence of gastrointestinal (GI) irAEs in cancer patients on PPIs (exposed) versus cancer patients who were not on PPIs (unexposed).
RESULTS
Three hundred and sixty three patients' records (248 M/115F, median age 69) were reviewed. Twenty-three exposed patients (92%) developed GI irAEs while only two unexposed patients (8%) developed GI irAEs (hazard ratio [HR] 13.22, 95% confidence interval [CI] 3.11-56.10, p < 0.000). This HR was confirmed after weighting for the propensity score (HR15.13 95% CI 3.22-71.03, p < 0.000).
CONCLUSION
Chronic PPI use is associated with an increased risk of GI irAES.
简介
肠道微生物群（GM）可以影响免疫介导的不良反应（irAEs）的发病机制。质子泵抑制剂（PPIs）可以影响 GM 的完整性，但它们在促进 irAEs 中的作用仍知之甚少。
方法
在这项回顾性单中心队列研究中，主要终点是评估接受质子泵抑制剂（暴露组）和未接受质子泵抑制剂（未暴露组）的癌症患者发生胃肠道（GI）irAEs 的发生率。
结果
回顾了 363 名患者的记录（248 名男性/115 名女性，中位年龄 69 岁）。23 名暴露组患者（92%）发生了 GI irAEs，而仅 2 名未暴露组患者（8%）发生了 GI irAEs（风险比 [HR] 13.22，95%置信区间 [CI] 3.11-56.10，p<0.000）。在对倾向评分进行加权后，该 HR 得到了证实（HR15.13 95% CI 3.22-71.03，p<0.000）。
结论
慢性 PPI 使用与 GI irAEs 的风险增加相关。
Zotero 插件