TY - T1的多发性硬化的风险在用户间的抗肿瘤坏死因子α4加拿大省份的JF -神经学乔-神经病学SP - e558 LP - e567做- 10.1212 / WNL。首页0000000000201472六世- 100 - 6盟Lingyi李盟- j·安东尼奥Avina-Zubieta AU -查尔斯·n·伯恩斯坦盟Gilaad g·卡普兰AU -海伦Tremlett盟回族谢盟Juan-Nicolas Pena-Sanchez AU -露丝安上盟Mahyar Etminan Y1 - 2023/02/07 UR - //www.ez-admanager.com/content/100/6/e558.abstract N2 -背景和目标抗肿瘤坏死因子α(TNFα)代理类生物药物用于治疗一首页些免疫介导的疾病的。多发性硬化(MS)的风险增加和他们的使用已经被提出过,但研究是有限的。相关的人群流行病学数据链接anti-TNFα女士稀缺。目的是比较女士的风险anti-TNFα用户提供使用者在风湿性疾病患者(RD)或炎症性肠病(IBD)。嵌套病例对照研究方法。以人群为基础的健康护理联系数据库从4加拿大省份。所有采访或IBD患者居住在参加省2000年1月至2018年3月被确定病例定义进行验证。任何anti-TNFα分配索引日期前2年(MS发病)被确认。事件发病病例女士确定使用验证算法。5控制匹配每个女士用例基于出生年±3年,疾病持续时间和健康权威(基于居住地区)。 Conditional logistic regressions were used to calculate the incidence rate ratio (IRR) after adjusting for potential confounders. A meta-analysis was conducted to provide pooled estimates across provinces using random-effects models.Results Among 296,918 patients with RD patients, 462 MS cases (80.1% female, mean [SD] age, 47.4 [14.6] years) were matched with 2,296 controls (59.5% female, mean [SD] age, 47.4 [14.5] years). Exposure to anti-TNFα occurred in 18 MS cases and 42 controls. After adjusting for matching variables, sex, and the Charlson Comorbidity Index, the pooled IRR was 2.05 (95% CI, 1.13–3.72). Among 84,458 patients with IBD, 190 MS cases (69.5% female, mean [SD] age, 44.3 [12.3] years) were matched with 943 controls (54.1% female, mean [SD] age, 44.2 [12.2] years). Exposure to anti-TNFα occurred in 23 MS cases and 98 controls. The pooled adjusted IRR was 1.35 (95% CI, 0.70–2.59).Discussion The use of anti-TNFα was associated with an increased risk of MS compared with nonusers, especially among patients with RD. These findings could help clinicians and patients with RD to make more informed treatment decisions. Further studies are needed to validate these results for patients with IBD.CCI=Charlson Comorbidity Index; cDAG=causal direct acyclic graph; DMARD=disease-modifying antirheumatic drug; IBD=inflammatory bowel disease; IRR=incidence rate ratio; MS=multiple sclerosis; NCC=nested case control; NSAID=nonsteroidal anti-inflammatory drug; RD=rheumatic disease; TNFα=tumor necrosis factor α ER -