A Large-Scale Study Indicates Increase in the Risk of Epilepsy in Patients With Different Risk Factors, Including Rheumatoid Arthritis.
A Large-Scale Study Indicates Increase in the Risk of Epilepsy in Patients With Different Risk Factors, Including Rheumatoid Arthritis.
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DOI：
10.1097/md.0000000000001485
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发表时间：
2015-09
期刊：
影响因子：
1.6
通讯作者：
Kao CH
中科院分区：
文献类型：
--
作者：
Chang KH;Hsu YC;Chang MY;Lin CL;Wu TN;Hwang BF;Chen CY;Liu HC;Kao CH
类风湿性关节炎（RA）可伴有周围神经病变和中枢神经系统的炎症反应。炎症过程在癫痫中起着关键作用。因此，我们进行了这项研究，以确定RA患者癫痫的风险。RA队列包括2000年至2011年期间新诊断为RA的20岁及以上患者，数据来自灾难性疾病患者数据库登记处。根据年龄、性别和RA诊断年份，将非RA患者与RA队列以1：1的比例进行频率匹配。RA组癫痫的总体粗风险比（HR）是对照组的1.27倍。校正年龄、性别、合并症和药物后，与非RA患者相比，RA患者癫痫风险增加（校正HR [aHR]= 1.52，95%置信区间[CI]= 1.12-2.07）。 与使用非甾体抗炎药（NSAID）≤ 560天的RA患者相比，使用NSAID 1181 - 2145天和>2145天的RA患者癫痫风险显著降低（分别为aHR= 0.35，95%CI = 0.24-0.52和aHR = 0.15，95%CI =0.09-0.24）。 这项研究提供了令人信服的证据表明，RA患者癫痫的风险增加。非甾体类抗炎药治疗的时间与类风湿关节炎患者癫痫的风险呈负相关。
Peripheral neuropathy and inflammatory reactions of the central nervous system may accompany rheumatoid arthritis (RA). Inflammatory processes play a critical role in epilepsy. Therefore, we conducted this study to determine the risk of epilepsy in patients with RA. The RA cohort comprised patients ages 20 years and older who were newly diagnosed with RA between 2000 and 2011, with data obtained from the Registry of Catastrophic Illnesses Patient Database. Patients without RA were frequency matched with an RA cohort at a 1:1 ratio according to age, sex, and year of RA diagnosis. The overall crude hazard ratio (HR) for epilepsy was 1.27-fold higher in the RA cohort compared with that in the controls. After adjustment for age, sex, comorbidities, and medications, the patients with RA were associated with an increased risk of epilepsy compared with those without RA (adjusted HR [aHR] = 1.52, 95% confidence interval [CI] = 1.12–2.07). Compared with the RA patients with ≤ 560 days of nonsteroidal anti-inflammatory drug (NSAID) use, the RA patients with 1181 to 2145 and >2145 days of NSAID use had a significantly lower risk of epilepsy (aHR = 0.35, 95% CI = 0.24–0.52 and aHR = 0.15, 95% CI = 0.09–0.24, respectively). This study provides compelling evidence of an increased risk of epilepsy in patients with RA. The period of NSAID treatment is negatively associated with the risk of epilepsy in RA patients.