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中国风湿性疾病孕妇的真实世界药物治疗:2016年至2021年的回顾性分析

Real-world pharmacological treatment of pregnant patients with rheumatic diseases from China: a retrospective analysis from 2016 to 2021.

作者信息

Jia Ji-Ning, Wang Xian-Li

机构信息

Department of Pharmacy, The Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.

出版信息

Front Pharmacol. 2024 Apr 17;15:1353293. doi: 10.3389/fphar.2024.1353293. eCollection 2024.

Abstract

We investigated trends in the use of therapeutic drugs for pregnant patients with rheumatic diseases in nine Chinese cities (Beijing, Chengdu, Guangzhou, Harbin, Hangzhou, Shanghai, Shenyang, Tianjin, and Zhengzhou) to provide a reference for drug use in clinic. Outpatient prescription data for pregnant patients diagnosed with rheumatic diseases in nine cities across China in 2016-2021 were extracted from the Hospital Prescription Cooperation Project of the Hospital Pharmacy Professional Committee of the Chinese Pharmaceutical Association. A retrospective analysis was then performed, incorporating data on patient age, defined daily doses (DDDs), defined daily cost (DDC), and other metrics. In 2016-2020, more than 70% of the pregnant patients diagnosed with rheumatic diseases in these nine cities were 25 to < 35 years of age. The most common rheumatic diseases during pregnancy were antiphospholipid antibody syndrome (APS) and systemic lupus erythematosus (SLE). In terms of the routine use of daily therapeutic drugs, the DDDs of low molecular weight heparins (LMWHs), glucocorticoids, and immunosuppressive agents dominated the top three. Intravenous immunoglobulin (IVIG) and tumor necrosis factor inhibitors (TNFi) have been used since 2019 and had been in the forefront of the DDC. The number and total cost of prescriptions for therapeutic drugs of pregnancy complicated by rheumatic diseases, have increased significantly over the study interval. Conventional therapeutic drugs, especially glucocorticoids, LMWHs, and hydroxychloroquine were the most widely used drugs in pregnant patients with rheumatic diseases. However, IVIG and TNFi, relatively high cost, have shown gradual increases in clinical use since 2019.

摘要

我们调查了中国九个城市(北京、成都、广州、哈尔滨、杭州、上海、沈阳、天津和郑州)妊娠合并风湿性疾病患者使用治疗药物的趋势,为临床用药提供参考。从中国药学会医院药学专业委员会医院处方合作项目中提取了2016 - 2021年中国九个城市妊娠合并风湿性疾病患者的门诊处方数据。然后进行回顾性分析,纳入患者年龄、限定日剂量(DDD)、限定日费用(DDC)等数据指标。在2016 - 2020年期间,这九个城市中超过70%的妊娠合并风湿性疾病患者年龄在25至<35岁之间。孕期最常见的风湿性疾病是抗磷脂抗体综合征(APS)和系统性红斑狼疮(SLE)。在日常治疗药物的常规使用方面,低分子肝素(LMWH)、糖皮质激素和免疫抑制剂的限定日剂量位居前三。静脉注射免疫球蛋白(IVIG)和肿瘤坏死因子抑制剂(TNFi)自2019年起开始使用,且限定日费用一直名列前茅。在研究期间,妊娠合并风湿性疾病治疗药物的处方数量和总费用显著增加。传统治疗药物,尤其是糖皮质激素、低分子肝素和羟氯喹是妊娠合并风湿性疾病患者中使用最广泛的药物。然而,费用相对较高的静脉注射免疫球蛋白和肿瘤坏死因子抑制剂自2019年起临床使用呈逐渐增加趋势。

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Autoimmun Rev. 2020 Dec;19(12):102685. doi: 10.1016/j.autrev.2020.102685. Epub 2020 Oct 22.
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Antirheumatic medications in pregnancy and breastfeeding.妊娠和哺乳期的抗风湿药物。
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Managing antiphospholipid syndrome in pregnancy.妊娠合并抗磷脂综合征的管理。
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