■吸烟和使用非甾体抗炎药(NSAIDs)乙酰水杨酸(ASA),质子泵抑制剂(PPI),5-羟色胺再摄取抑制剂(SSRIs),和他汀类药物与显微镜下结肠炎(MC)有关。
■我们调查了这些因素是否与被诊断为MC的患者重复布地奈德治疗相关。
■回顾性观察性研究。
■在2006年至2022年间,在我们的诊所经组织学证实诊断为MC的所有患者均被确定。登记诊断前后的基线因素和处方药物。研究了危险因素对口服布地奈德的可能性和第二疗程布地奈德的可能性的影响。
■患者(n=183),平均年龄为62.3岁[标准差(SD):13.3岁],在诊断后随访中位5年(第25-75百分位数4-10年)。总之,138例患者(75%)在诊断后至少有一个布地奈德处方,90例患者(49%)至少有一次布地奈德临床复发.在临床复发前1年内服用NSAIDs的患者临床复发几率较高[优势比(OR):3.70,95%置信区间(CI):1.06-12.9],但使用ASA的临床复发风险没有增加(OR:0.99,95%CI:0.39-2.90),PPI(OR:1.09,95%CI:0.45-2.63),SSRI(OR:1.41,95%CI:0.82-2.44),或他汀类药物(OR:0.83,95%CI:0.35-1.99)。吸烟者和/或处方NSAID之间没有关联,ASA,PPI,SSRI,基线时的他汀类药物和诊断后1年内口服布地奈德处方的几率。
■第二疗程布地奈德处方的风险与接受非甾体抗炎药处方有关,但与使用ASA无关,PPI,SSRIs,和他汀类药物。
使用药物和镜下结肠炎患者出现第二个疗程布地奈德镜下结肠炎的几率是慢性腹泻的常见原因。以前的研究表明,使用非甾体抗炎药,乙酰水杨酸,质子泵抑制剂,5-羟色胺再摄取抑制剂和他汀类药物更常用于后来发展为显微镜下结肠炎的患者。我们旨在研究这些药物是否也与183例已知显微镜下结肠炎患者用布地奈德治疗的疾病爆发风险增加有关。建议口服布地奈德6-8周用于镜下结肠炎的疾病发作。在我们的研究中,90例患者(49%)可能是由于疾病发作而被处方服用布地奈德第二疗程。我们发现,在接受非甾体类抗炎药的镜下结肠炎患者中,服用布地奈德第二疗程的可能性更高,但其他镜下结肠炎“风险药物”的风险更高。
UNASSIGNED: Smoking and the use of non-steroidal anti-inflammatory drugs (NSAIDs) acetylsalicylic acid (ASA), proton pump inhibitors (PPIs), serotonin reuptake inhibitors (SSRIs), and statins have been associated with microscopic colitis (MC).
UNASSIGNED: We investigated whether these factors were associated with repeated budesonide treatments in patients diagnosed with MC.
UNASSIGNED: Retrospective observational study.
UNASSIGNED: All patients with a histologically verified diagnosis of MC at our clinic between the years 2006 and 2022 were identified. Baseline factors and drugs prescribed before and after diagnosis were registered. The influence of risk factors on the odds of having a prescription of oral budesonide and the odds of having a second course of budesonide was studied.
UNASSIGNED: Patients with MC (n = 183) with a mean age of 62.3 years [standard deviation (SD): 13.3 years] were followed for a median of 5 years (25th-75th percentile 4-10 years) after diagnosis. In all, 138 patients (75%) had at least one prescription of budesonide after diagnosis, and 90 patients (49%) had at least one clinical relapse treated with budesonide. Patients who had been prescribed NSAIDs within 1 year before clinical relapse had higher odds for clinical relapse [odds ratio (OR): 3.70, 95% confidence interval (CI): 1.06-12.9] but there was no increased risk for clinical relapse for the use of ASA (OR: 0.99, 95% CI: 0.39-2.90), PPIs (OR: 1.09, 95% CI: 0.45-2.63), SSRI (OR: 1.41, 95% CI: 0.82-2.44), or statins (OR: 0.83, 95% CI: 0.35-1.99). No association was seen between being a smoker and/or being prescribed NSAID, ASA, PPI, SSRI, and statins at baseline and the odds of having a prescription of oral budesonide within 1 year after diagnosis.
UNASSIGNED: The risk of being prescribed a second course of budesonide is associated with receiving a prescription of NSAIDs but not with the use of ASA, PPIs, SSRIs, and statins.
The use of drugs and the odds for patients with microscopic colitis of having a second course of budesonide Microscopic colitis is a common cause of chronic diarrhea. Previous studies have shown that the use of non-steroidal anti-inflammatory drugs, acetylsalicylic acid, proton-pump inhibitors, serotonin reuptake inhibitors and statins are used more often in patients who later develop microscopic colitis. We aimed to study if these drugs also had an association to an increased risk of disease flares treated with budesonide in 183 patients with known microscopic colitis. Oral budesonide for 6-8 weeks are recommended for disease flares of microscopic colitis. In our study, 90 patients (49%) were prescribed a second course of budesonide probably due to a disease flare. We found a higher odds for being prescribed a second course of budesonide in patients with microscopic colitis who were prescribed non-steroidal anti-inflammatory drugs but no higher risk for the other ‘risk drugs’ for microscopic colitis.