Comment on the article by Lockshin.
Comment on the article by Lockshin.
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评论 Lockshin 的文章。
DOI：
10.1002/art.1780330425
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发表时间：
1990
影响因子：
--
通讯作者：
N. Rothfield
中科院分区：
文献类型：
--
作者：
A. Parke;M. Peterson;N. Rothfield
来自美国风湿病协会医学信息系统（ARAMIS）关于硫唑嘌呤诱导的肿瘤的数据（Singh G, Fries JF, Spitz P， Williams CA：硫唑嘌呤在类风湿关节炎中的毒性作用：一个国家上市后的视角）。关节炎（Rheum, 322337443, 1989）在统计上是无懈可击的。然而，我质疑它们的临床意义。治疗的持续时间，我相信。随访20.8 （21.1 SEM）个月。研究显示药物性肿瘤风险的作者指出，增加的风险可能直到许多年后才会被发现（Baker GL, Kahl LE, Zee BC, Stoker BL, Agarwal AK， Medsger TA：类风湿关节炎治疗后的恶性肿瘤：长期病例对照随访研究）。中华医学杂志[J]， 2004(1)。虽然在ARAMIS结果之后的讨论表明，有必要进行更长的随访以“提供明确的答案”，但我担心，较短的研究只会把水搅浑，因为它增加了未能证明两者之间存在关联的参考研究的列表。
The data from the American Rheumatism Association Medical Information System (ARAMIS) about the lack of azathioprine-induced neoplasia (Singh G, Fries JF, Spitz P, Williams CA: Toxic effects of azathioprine in rheumatoid arthritis: a national post-marketing perspective. Arthritis Rheum 322337443, 1989) are, I’m sure, statistically unimpeachable. However, I question their clinical significance. The duration of therapy and, I believe. followup was 20.8 (2 1.1 SEM) months. The authors of studies that have shown a risk of drug-induced neoplasia have pointed out that the increased risk may, not be seen until many years later (Baker GL, Kahl LE, Zee BC, Stoker BL, Agarwal AK, Medsger TA: Malignancy following treatment of rheumatoid arthritis with cyclophosphamide: long term case control follow up study. Am J Med 83: l-9, 1987). While the discussion following the ARAMIS results suggests that a longer followup is necessary to “provide an unequivocal answer,” I am concerned that shorter studies merely muddy the waters by adding to the list of referenced studies that have failed to demonstrate an association.