背景:为了确定秋水仙碱对免疫介导的炎症性疾病(IMID)患者癌症风险的影响。
方法:这是一项基于台湾国家健康保险研究数据库(NHIRD)的时间依赖性倾向匹配一般人群研究。根据国际疾病分类,我们确定了2000年至2012年间新诊断的IMID患者(n=111,644)。第九次修订,临床修改(ICD-9-CM)-274,712、135、136.1、279.49、518.3、287.0、696.0、696.1、696.8、420、429.4、710.0、710.1、710.3、710.4、714.0、720、55.0、55.1、55.9、556。
方法:年龄≥20岁,如果患者在随访1年内至少有这些疾病诊断要求,and,这些患者至少有两次门诊就诊或一次住院就诊.根据年龄进行倾向匹配后,性别,合并症,药物和索引日期,IMID患者进入秋水仙碱使用者(N=16,026)和秋水仙碱非使用者(N=16,026)。此外,使用时间依赖性Cox模型分析倾向匹配的秋水仙碱使用者与非使用者的癌症风险.使用Cox比例回归分析累积癌症发病率。我们在调整性别后计算了癌症的调整风险比(aHRs)及其95%置信区间(95%CIs),年龄,合并症,以及使用包括乙酰半胱氨酸在内的药物,戒烟药物,如尼古丁替代药物(尼古丁贴片)和药丸药物(伐尼克林),抗炎药和免疫抑制剂药物。
结果:比较秋水仙碱非使用者,所有癌症风险都轻度减弱,所有癌症的(aHR(95%CI))为(0.84(0.55,0.99))。同时,秋水仙素使用者与结直肠癌发病率较低有关,(aHR(95%CI))为(0.22(0.19,0.89))。那些年龄<65岁和男性/女性有秋水仙碱使用者也与结直肠癌风险较低相关。此外,秋水仙碱>20天与较低的aHR用于结直肠癌。
结论:秋水仙碱与IMID患者所有癌症和结直肠癌形成的较低aHR相关。
BACKGROUND: To determine the effect of colchicine on cancer risk in patients with the immune-mediated inflammatory diseases (IMIDs)-related to colchicine use.
METHODS: This is a time-dependent propensity-matched general population
study based on the National Health Insurance Research Database (NHIRD) of Taiwan. We identified the IMIDs patients (n = 111,644) newly diagnosed between 2000 and 2012 based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)-274,712, 135, 136.1, 279.49, 518.3, 287.0, 696.0, 696.1, 696.8, 420, 429.4, 710.0, 710.1, 710.3, 710.4, 714.0, 720, 55.0, 55.1, 55.9, 556.
METHODS: aged ≧ 20 years, if a patient had at least these disease diagnosis requirements within 1 year of follow-up, and, these patients had at least two outpatient visits or an inpatient visit. After propensity-matched according to age, sex, comorbidities, medications and index date, the IMIDs patients enter into colchicine users (N = 16,026) and colchicine nonusers (N = 16,026). Furthermore, time-dependent Cox models were used to analyze cancer risk in propensity-matched colchicine users compared with the nonusers. The cumulative cancer incidence was analyzed using Cox proportional regression analysis. We calculated adjusted hazard ratios (aHRs) and their 95% confidence intervals (95% CIs) for cancer after adjusting for sex, age, comorbidities, and use of medicine including acetylcysteine, medication for smoking cessation such as nicotine replacement medicines (the nicotine patch) and pill medicines (varenicline), anti-inflammatory drugs and immunosuppressant drugs.
RESULTS: Comparing the colchicine nonusers, all cancer risk were mildly attenuated, the (aHR (95% CI)) of all cancer is (0.84 (0.55, 0.99)). Meanwhile, the colchicine users were associated with the lower incidence of the colorectal cancer, the (aHRs (95% CI)) is (0.22 (0.19, 0.89)). Those aged < 65 years and male/female having the colchicine users were associated with lower risk the colorectal cancer also. Moreover, the colchicine > 20 days use with the lower aHR for colorectal cancer.
CONCLUSIONS: Colchicine was associated with the lower aHR of the all cancer and colorectal cancer formation in patients with the IMIDs.