Toka Alsulaim, Noor Alhassan, Hala Khalil, Abdullah Almutlaq
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引用次数: 5
Abstract
Objective: To study the effect of tocilizumab initiation on the lipid profile, in correlation to a composite of any cardiovascular events.
Methods: A retrospective cohort study, using data from the King Faisal Specialist Hospital & Research Centre database, from January 2014 to December 2019. Patients with rheumatoid arthritis or juvenile idiopathic arthritis who were ≥18 years old, initiated either on tocilizumab or other biologic treatment (anti-TNFs or Rituximab), were included, with a follow-up interval duration at a minimum of 6-12 months up to 3-5 years. Any patient with established cardiovascular disease or aged <18 were excluded.
Results: Only one cardiovascular mortality was reported in the tocilizumab group. Fifty percent of patients reached high cholesterol levels ≥ 5.2 mmol/L and LDL ≥ 3.37 mmol/L in the tocilizumab group at 36 months in a shorter time period compared to controls (60 months), P 0.001. There were no significant differences between groups for statin use (27% vs. 28%) However, there was a significantly higher mean dose of atorvastatin in the tocilizumab group compared to controls (20.6 mg vs. 16.6 mg, P 0.03).
Conclusion: There was a lack of evidence of increased cardiovascular risk in correlation to hyperlipidemia secondary to tocilizumab treatment.
目的:研究托珠单抗起始对血脂的影响,与任何心血管事件的复合相关。方法:回顾性队列研究,使用2014年1月至2019年12月费萨尔国王专科医院和研究中心数据库的数据。纳入≥18岁的类风湿关节炎或青少年特发性关节炎患者,开始接受tocilizumab或其他生物治疗(抗tnf或利妥昔单抗),随访时间间隔至少为6-12个月至3-5年。结果:托珠单抗组仅报告1例心血管疾病死亡。与对照组(60个月)相比,tocilizumab组50%的患者在36个月内达到高胆固醇水平≥5.2 mmol/L和LDL≥3.37 mmol/L, P < 0.001。他汀类药物的使用在两组间无显著差异(27% vs 28%)。然而,托珠单抗组阿托伐他汀的平均剂量明显高于对照组(20.6 mg vs 16.6 mg, P 0.03)。结论:缺乏与托珠单抗治疗继发高脂血症相关的心血管风险增加的证据。