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在真实世界中,接受阿普斯特治疗的银屑病或银屑病关节炎患者的糖尿病和肥胖负担以及心脏代谢参数的改善情况。

Diabetes and obesity burden and improvements in cardiometabolic parameters in patients with psoriasis or psoriatic arthritis receiving apremilast in a real-world setting.

作者信息

Cavanaugh Cristi, Orroth Kate, Qian Xi, Kumparatana Pam, Klyachkin Yuri, Colgan Stephen, Cordey Myriam

机构信息

OM1, Inc, Boston, Massachusetts.

Amgen, Inc, Thousand Oaks, California.

出版信息

JAAD Int. 2024 Mar 9;16:244-251. doi: 10.1016/j.jdin.2024.02.016. eCollection 2024 Sep.

DOI:10.1016/j.jdin.2024.02.016
PMID:39072263
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11279948/
Abstract

INTRODUCTION

Patients with psoriasis and psoriatic arthritis have a higher prevalence of cardiometabolic comorbidities compared to the general population. Clinical data suggest apremilast may reduce weight and glycated hemoglobin (HbA1c).

OBJECTIVE

To describe changes in cardiometabolic parameters among patients with psoriasis and psoriatic arthritis newly treated with apremilast by prediabetes/diabetes or obesity status.

METHODS

This was a retrospective cohort study of electronic medical records from patients with psoriasis and/or psoriatic arthritis in the OM1 Real-World Data Cloud who newly initiated apremilast. Changes from baseline in body mass index, weight, HbA1c, and lipids were evaluated at 6 and 12 months using a multivariable linear regression model stratified by prediabetes/diabetes or obesity status.

RESULTS

Of 8487 patients initiating apremilast, 24% had diabetes. Of 8250 patients with body mass index available, 27% were obese and 34% were severely obese. Patients experienced decreases in body mass index and weight at 6 and 12 months regardless of diabetes or obesity status, with the greatest reductions seen in those with diabetes and obesity. Reductions in HbA1c at 6 months were seen in patients without diabetes and patients with severe obesity.

CONCLUSIONS

Treatment with apremilast may provide the greatest cardiometabolic benefit to those with the greatest burden of cardiometabolic disease.

摘要

引言

与普通人群相比,银屑病和银屑病关节炎患者发生心脏代谢合并症的患病率更高。临床数据表明,阿普斯特可能减轻体重并降低糖化血红蛋白(HbA1c)水平。

目的

描述新接受阿普斯特治疗的银屑病和银屑病关节炎患者中,根据糖尿病前期/糖尿病或肥胖状况,其心脏代谢参数的变化情况。

方法

这是一项对OM1真实世界数据云中银屑病和/或银屑病关节炎患者电子病历的回顾性队列研究,这些患者新开始使用阿普斯特。使用多变量线性回归模型,在6个月和12个月时评估体重指数、体重、HbA1c和血脂相对于基线的变化情况,该模型按糖尿病前期/糖尿病或肥胖状况分层。

结果

在开始使用阿普斯特的8487例患者中,24%患有糖尿病。在有体重指数数据的8250例患者中,27%为肥胖,34%为重度肥胖。无论糖尿病或肥胖状况如何,患者在6个月和12个月时体重指数和体重均有所下降,糖尿病和肥胖患者下降幅度最大。在无糖尿病患者和重度肥胖患者中,6个月时HbA1c水平有所降低。

结论

阿普斯特治疗可能对心脏代谢疾病负担最重的患者提供最大的心脏代谢益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/475b/11279948/6dd43b558bb7/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/475b/11279948/1839f3a23a28/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/475b/11279948/1602dc62b2ea/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/475b/11279948/f52dbb969413/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/475b/11279948/6dd43b558bb7/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/475b/11279948/1839f3a23a28/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/475b/11279948/1602dc62b2ea/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/475b/11279948/f52dbb969413/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/475b/11279948/6dd43b558bb7/gr4.jpg

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Am J Clin Dermatol. 2023 Sep;24(5):809-820. doi: 10.1007/s40257-023-00783-7. Epub 2023 Jun 14.
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EULAR points to consider for the definition of clinical and imaging features suspicious for progression from psoriasis to psoriatic arthritis.EULAR 提出的用于定义银屑病向银屑病关节炎进展的临床和影像学特征的考虑因素。
Ann Rheum Dis. 2023 Sep;82(9):1162-1170. doi: 10.1136/ard-2023-224148. Epub 2023 Jun 9.
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JAMA Dermatol. 2022 Dec 1;158(12):1394-1403. doi: 10.1001/jamadermatol.2022.3862.
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Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA): updated treatment recommendations for psoriatic arthritis 2021.银屑病关节炎研究和评估组(GRAPPA):2021 年银屑病关节炎更新的治疗建议。
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