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Does Abatacept Increase Postoperative Adverse Events in Rheumatoid Arthritis Compared with Conventional Synthetic Disease-modifying Drugs?

与常规合成疾病修饰药物相比,阿巴西普是否会增加类风湿关节炎术后不良事件?

  • 影响因子:2.67
  • DOI:10.3899/jrheum.181100
  • 作者列表:"Ito H","Tsuji S","Nakayama M","Mochida Y","Nishida K","Ishikawa H","Kojima T","Matsumoto T","Kubota A","Mochizuki T","Sakuraba K","Matsushita I","Nakajima A","Hara R","Haraguchi A","Matsubara T","Kanbe K","Nakagawa N","Hamaguchi M","Momohara S","JOSRA Consortium.
  • 发表时间:2020-04-01
Abstract

OBJECTIVE:To investigate whether abatacept (ABA) causes more adverse events (AE) than conventional synthetic disease-modifying antirheumatic drugs (csDMARD) after orthopedic surgery in patients with rheumatoid arthritis (RA). METHODS:A retrospective multicenter nested case-control study was performed in 18 institutions. Patients receiving ABA (ABA group) were matched individually with patients receiving csDMARD and/or steroids (control group). Postoperative AE included surgical site infection, delayed wound healing, deep vein thrombosis or pulmonary embolism, flare, and death. The incidence rates of the AE in both groups were compared with the Mantel-Haenszel test. Risk factors for AE were analyzed by logistic regression model. RESULTS:A total of 3358 cases were collected. After inclusion and exclusion, 2651 patients were selected for matching, and 194 patients in 97 pairs were chosen for subsequent comparative analyses between the ABA and control groups. No between-group differences were detected in the incidence rates of each AE or in the incidence rates of total AE (control vs ABA: 15.5% vs 20.7% in total, 5.2% vs 3.1% in death). CONCLUSION:Compared with csDMARD and/or steroids without ABA, adding ABA to the treatment does not appear to increase the incidence rates of postoperative AE in patients with RA undergoing orthopedic surgery. Large cohort studies should be performed to add evidence for the perioperative safety profile of ABA.

摘要

目的: 探讨阿巴西普 (ABA) 在类风湿关节炎 (RA) 患者骨科手术后是否比常规合成改善病情抗风湿药 (csDMARD) 引起更多的不良事件 (AE)。 方法: 在 18 家机构进行回顾性多中心巢式病例对照研究。接受 ABA 的患者 (ABA 组) 与接受 csDMARD 和/或类固醇的患者 (对照组) 单独匹配。术后 AE 包括手术部位感染、伤口愈合延迟、深静脉血栓形成或肺栓塞、复发和死亡。用 Mantel-Haenszel 试验比较两组 AE 的发生率。采用 logistic 回归模型分析 AE 的危险因素。 结果: 共收集病例 3358 例。纳入和排除后,选择 2651 例患者进行匹配,选择 97 对中的 194 例患者进行随后的 ABA 和对照组之间的比较分析。各组 AE 发生率或总 AE 发生率均未检测到组间差异 (对照组 vs ABA: 15.5% vs 20.7%,死亡 5.2% vs 3.1%)。 结论: 与无 ABA 的 csDMARD 和/或类固醇相比,在治疗中加入 ABA 似乎不会增加 RA 骨科手术患者术后 AE 的发生率。应进行大型队列研究,为 ABA 的围手术期安全性提供证据。

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影响因子:1.64
发表时间:2020-01-29
DOI:10.1080/13813455.2020.1716810
作者列表:["Fattah SA","Abdel Fattah MA","Mesbah NM","Saleh SM","Abo-Elmatty DM","Mehanna ET"]

METHODS:ZNF804a and CDK1 genes code for proteins involved in inflammatory pathways. This study aimed to investigate the correlation of ZNF804a and CDK1 expression profiles in RA with the activity and the severity of the disease and to assess their association with inflammatory reactions in the Egyptian RA patients. ZNF804a and CDK1 expression profiles were assessed using quantitative PCR (qRT-PCR). Clinical and laboratory parameters were evaluated. ZNF804a expression was down-regulated by 0.177-fold while CDK1 expression was up-regulated to 3.29-fold in RA patients compared with healthy controls ( < .001). ZNF804a down-regulation was negatively correlated with CRP, RF, disease activity score of 28 joints (DAS) using CRP (DAS-CRP) and TNF-α. CDK1 overexpression was correlated with IFN-1 and ACPA in RA patients. ZNF804a and CDK1 genes are implicated in RA pathogenesis due to their influences on TNF-α and IFN-1 which contribute to inflammation in RA patients.

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影响因子:9.18
发表时间:2020-01-29
DOI:10.1136/annrheumdis-2019-216539
作者列表:["Emery P","Horton S","Dumitru RB","Naraghi K","van der Heijde D","Wakefield RJ","Hensor EMA","Buch MH"]

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