风湿

柳氮磺吡啶可降低AS的心血管病风险

作者:Tam HW,翻译:北医三院刘蕊 来源:中国风湿病公众论坛 日期:2017-11-29
导读

         柳氮磺吡啶可降低强直性脊柱炎患者的心血管病风险

        目的:评估塞来昔布和柳氮磺吡啶对强直性脊柱炎(AS)患者心血管风险的影响。

        方法:我们进行了为期10年的基于人群的回顾性队列研究。从台湾国民健康保险(NHI)数据库中抽取了1208例AS患者和19328例非AS患者。我们比较了这两组患者,以确定非甾体抗炎药物和柳氮磺胺吡啶的暴露差异及其对心血管风险的影响。非分歧性变量应用卡方检验,连续变量应用t检验进行单变量分析。进行Cox比例风险模型研究发生心血管疾病(CVD)的风险。

        结果:与非AS对照组相比,AS患者校正的CVD风险比(HR)为1.72(CI = 1.46-2.02,P <0.01)。随着疾病的进展,风险显着增加。塞来昔布和柳氮磺吡啶的使用在两组患者中均提供了针对CVD的保护作用。两种药物在高累积限定日剂量(DDD),以及塞来昔布单药在高累积限定日剂量下分别对AS患者组和对照组显示出对CVD的显着保护作用。柳氮磺胺吡啶≥0.5DDD(1000mg /天)降低AS患者的CVD风险(HR = 0.65,CI = 0.43-0.998,P <0.05)。

        结论:在这项基于人群的回顾性队列研究中,柳氮磺吡啶在其最佳剂量下降低了AS患者的CVD风险。塞来考昔对于AS患者的CVD风险是中性的。

        附原文:

        AbstractAIM: To assess the effects of celecoxib and sulfasalazine on cardiovascular risk in patients with ankylosing spondylitis (AS).METHODS: We performed a 10-year population-based retrospective cohort study. A total of 1208 AS patients and 19 328 non-AS patients were sampled from the Taiwan National Health Insurance (NHI) database. We compared these two groups of patients to identify the differences in the exposure of non-steroidal anti-inflammatory drugs and sulfasalazine and their effects on cardiovascular risk. Univariate analyses were performed using Chi-squared tests for dichotomous variables and t-tests for continuous variables. Cox proportional hazard models were conducted to investigate the risk of developing cardiovascular diseases (CVD).RESULTS: AS patients had an adjusted hazard ratio (HR) of 1.72 (CI = 1.46-2.02, P < 0.01) for CVD compared with non-AS controls. The risk increased significantly with the progression of the disease. The use of celecoxib and sulfasalazine provided protective effects against CVD in both groups of patients. Both drugs at high cumulative defined daily doses (DDD) and celecoxib alone at high cumulative DDD showed significant protective effects against CVD in AS patients and the control group, respectively. Sulfasalazine at ≥ 0.5 DDD (1000 mg/day) reduced CVD risk in patients with AS (HR = 0.65, CI = 0.43-0.998, P < 0.05).CONCLUSIONS: In this population-based retrospective cohort study, sulfasalazine at its optimal dose reduced CVD risk in patients with AS. Celecoxib was neutral regarding CVD risk in AS patients.

        引自:Tam HW1, Yeo KJ2,3, Leong PY2,3,et al.Sulfasalazine might reduce risk of cardiovascular diseases in patients with ankylosing spondylitis: A nationwide population-based retrospective cohort study. Int J Rheum Dis. 2017 Mar;20(3):363-370. doi: 10.1111/1756-185X.12986. Epub 2016 Dec 10.

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