- 期刊
- OpenAccess
The Risk of Serious Infections in Patients with Rheumatoid Arthritis Treated with Different Tumor Necrosis Factor a Inhibitors
類風濕性關節炎患者經不同抗腫瘤壞死因子藥物治療後比較其產生嚴重性感染的風險
摘要
目的：評估台中榮總於2007至2012年間使用恩博或復邁治療類風濕性關節炎的患者其產生嚴重性感染的風險是否有所差異。方法：回溯性收集使用恩博或復邁的類風濕性關節炎患者其基本資料、臨床表徵、檢查結果，以及紀錄恩博或復邁治療過程中產生的嚴重性感染。計算發生嚴重性感染的機率，以及分析是否有獨立的危險因子。結果：共595位病人被納入，其中319位（佔54%）使用恩博，另外276位（佔46%）使用復邁。整體發生嚴重性感染的機會是每百人年6.45，恩博為每百人年5.05，而復邁為每百人年8.28。經統計分析相對於恩博而言使用復邁確實有顯著較高的嚴重性感染率。此外，若使用抗腫瘤壞死因子藥物當時的年紀較大，或是原本有慢性肺部疾病的患者，也有較高的機會會發生嚴重性感染。結論：本研究族群中使用復邁比恩博有更高的嚴重性感染的風險。
並列摘要
Objective: To evaluate the risk of serious infection in patients with rheumatoid arthritis (RA) treated with etanercept or adalimumab between 2007 and 2012 in a single medical center. Methods: We retrospectively collected the demographic data, clinical characteristics, laboratory findings, and all episodes of serious infection during anti-tumor necrosis factor (TNF)-α therapy. The incidence rate was calculated from the observed number of serious infections and patient-years of follow-up. Univariate and multivariate logistic regression analyses were made to identify the independent predictors of serious infection. Results: A total of 595 patients were included in the analyses: 319 (54%) treated with etanercept and 276 (46%) treated with adalimumab. The overall incidence rate was 6.45/100 patient-years: 5.05/100 patient-years for etanercept and 8.28/100 patient-years for adalimumab. The risk of serious infection was significantly higher in adalimumab than in etanercept (adjusted OR: 2.01, 95% CI: 1.15-3.49, p=0.014). Advanced age at the start of TNF-α inhibitor therapy and chronic pulmonary diseases were associated with significantly higher independent risks for serious infection. Conclusion: The risk of serious infection in RA patients treated with adalimumab was significantly higher than that in RA patients treated with etanercept in this cohort.
延伸閱讀
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