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特应性皮炎患者的静脉血栓栓塞风险低于其他免疫介导的炎症性疾病:一项使用美国索赔数据的回顾性、观察性、比较队列研究。

Venous thromboembolism risk is lower in patients with atopic dermatitis than other immune-mediated inflammatory diseases: A retrospective, observational, comparative cohort study using US claims data.

机构信息

Division of Rheumatology, Department of Dermatology and Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts.

AbbVie Inc., North Chicago, Illinois.

出版信息

J Am Acad Dermatol. 2024 May;90(5):935-944. doi: 10.1016/j.jaad.2023.12.027. Epub 2023 Dec 24.

Abstract

BACKGROUND

Certain immune-mediated inflammatory diseases (IMIDs) may increase patients' risk for venous thromboembolisms (VTEs), yet how atopic dermatitis (AD) influences VTE risk remains unclear.

OBJECTIVE

Describe VTE incidence in patients with AD compared with other IMIDs and unaffected, AD-matched controls.

METHODS

This retrospective, observational, comparative cohort study used Optum Clinformatics United States claims data (2010-2019) of adults with AD, rheumatoid arthritis (RA), Crohn's disease (CD), ulcerative colitis (UC), psoriasis (PsO), psoriatic arthritis (PsA), or ankylosing spondylitis (AS). Unaffected control patients were matched 1:1 with patients with AD.

RESULTS

Of 2,061,222 patients with IMIDs, 1,098,633 had AD. Patients with AD had a higher VTE incidence (95% CI) than did unaffected, AD-matched controls (0.73 [0.72-0.74] versus 0.59 [0.58-0.60] cases/100 person-years). When controlling for baseline VTE risk factors, however, AD was not associated with increased VTE risk (HR 0.96 [0.90-1.02]). VTE risk was lower in patients with AD versus RA, UC, CD, AS, or PsA; VTE risk was similar to patients with PsO.

LIMITATIONS

Disease activity and severity were not accounted for.

CONCLUSION

AD did not increase VTE risk when accounting for underlying risk factors. AD was associated with lower VTE risk compared with several rheumatologic and gastrointestinal IMIDs.

摘要

背景

某些免疫介导的炎症性疾病(IMIDs)可能会增加患者发生静脉血栓栓塞症(VTE)的风险,但特应性皮炎(AD)如何影响 VTE 风险尚不清楚。

目的

描述 AD 患者与其他 IMIDs 以及无 AD 患者相比 VTE 的发病情况。

方法

本回顾性、观察性、比较队列研究使用了 Optum Clinformatics 美国索赔数据(2010-2019 年),纳入了 AD、类风湿关节炎(RA)、克罗恩病(CD)、溃疡性结肠炎(UC)、银屑病(PsO)、银屑病关节炎(PsA)或强直性脊柱炎(AS)的成年患者。无 AD 患者与 AD 患者 1:1 匹配。

结果

在 2061222 例 IMIDs 患者中,有 1098633 例患有 AD。与无 AD 匹配的对照组相比,AD 患者 VTE 的发病率(95%CI)更高(0.73[0.72-0.74]比 0.59[0.58-0.60]例/100 人年)。然而,在控制基线 VTE 风险因素后,AD 与增加的 VTE 风险无关(HR 0.96[0.90-1.02])。与 RA、UC、CD、AS 或 PsA 相比,AD 患者的 VTE 风险较低;与 PsO 患者的 VTE 风险相似。

局限性

未考虑疾病活动度和严重程度。

结论

在考虑潜在风险因素时,AD 不会增加 VTE 风险。与几种风湿性和胃肠 IMIDs 相比,AD 与较低的 VTE 风险相关。

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