贝伐珠单抗给药与台湾居民慢性肾脏病发展风险:一项基于人群的回顾性队列研究。

Administration of Bevacizumab and the Risk of Chronic Kidney Disease Development in Taiwan Residents: A Population-Based Retrospective Cohort Study.

机构信息

Department of Medical Research, Tungs' Taichung MetroHarbor Hospital, Taichung 435, Taiwan.

Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404, Taiwan.

出版信息

Int J Mol Sci. 2023 Dec 26;25(1):340. doi: 10.3390/ijms25010340.

Abstract

Vascular endothelial growth factor (VEGF) plays a significant role as a pro-angiogenic and pro-permeability factor within the kidney. Bevacizumab is a pharmaceutical monoclonal anti-VEGF antibody that inhibits the growth of new blood vessels, which blocks blood supply and thereby restricts tumor growth. Thus, we conducted a nationwide study to explore the risk of chronic kidney disease (CKD) development in Taiwan residents after bevacizumab therapy. We drew data from the extensive National Health Insurance Research Database (NHIRD), which encompasses data from >99% of Taiwan's population from 1995 onwards. Individuals who received bevacizumab between 2012-2018 were identified as the bevacizumab cohort, with the index date set at the first usage. We randomly selected dates within the study period for the control group to serve as index dates. We excluded patients with a history of CKD prior to the index date or those <20 years old. In both cohorts, patients' propensity scores matched in a 1:1 ratio based on sex, age, index year, income, urbanization level, comorbidities, and medications. We found patients treated with bevacizumab had a significantly higher risk of contracting CKD than patients without bevacizumab (adjusted hazard ratio = 1.35, 95% confidence interval = 1.35-1.73). The risk of CKD was 1.35-fold higher in participants with bevacizumab treatment than those in the control group. These findings suggest that close monitoring of CKD development after bevacizumab administration is needed.

摘要

血管内皮生长因子(VEGF)在肾脏中作为一种促血管生成和渗透性因子发挥重要作用。贝伐单抗是一种抑制新血管生长的制药单克隆抗 VEGF 抗体,阻断血液供应,从而限制肿瘤生长。因此,我们进行了一项全国性研究,以探讨台湾居民接受贝伐单抗治疗后发生慢性肾脏病(CKD)的风险。我们从广泛的国家健康保险研究数据库(NHIRD)中提取数据,该数据库涵盖了 1995 年以来台湾 99%以上人口的数据。将 2012-2018 年期间接受贝伐单抗治疗的个体确定为贝伐单抗队列,以首次使用日期为索引日期。我们在研究期间为对照组随机选择日期作为索引日期。排除了索引日期前有 CKD 病史或年龄<20 岁的患者。在两个队列中,基于性别、年龄、索引年、收入、城市化水平、合并症和药物,以 1:1 的比例对患者的倾向评分进行匹配。我们发现,接受贝伐单抗治疗的患者比未接受贝伐单抗治疗的患者发生 CKD 的风险显著更高(调整后的危险比=1.35,95%置信区间=1.35-1.73)。贝伐单抗治疗组参与者发生 CKD 的风险比对照组高 1.35 倍。这些发现表明,在接受贝伐单抗治疗后,需要密切监测 CKD 的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52d8/10778964/d818b907af97/ijms-25-00340-g001.jpg

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