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Risk of Developing Hypertension in Atopic Dermatitis Patients Receiving Long-term and Low-dose Cyclosporine: A Nationwide Population-based Cohort Study

김수연|김정은|손상욱|Sukil Kim|Yu Ri Woo|Arum Choi|송서원|Sang Hyun Cho
대한피부과학회 (Korean Dermalogical Association)|2024.04|Annals of Dermatology|제36권 제2호|pp. 112-119|DOI 10.5021/ad.23.099

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키워드

drugHypertensionAtopic dermatitisDose-response relationshipRiskCyclosporine
주제분류피부과학

초록

Background: Cyclosporine (CS) is a first-line immunosuppressive agent used to manage mod- erate to severe atopic dermatitis (AD). To date, the risk of developing hypertension associated with the long-term use of low-dose CS in AD patients is understudied. Objective: To determine the cumulative dose-dependent effect of CS on the risk of developing hypertension in patients with AD. Methods: A nationwide population-based retrospective cohort with 1,844,009 AD patients was built from the Korean National Health Insurance System database from 2005 to 2009. A Cox proportional-hazard regression analysis was performed according to patients’ CS treatment histor y adjusted for potential confounders. Results: Current use of CS was associated with an increased risk of developing hypertension (adjusted hazard ratio, 4.442; 95% confidence inter val, 3.761–5.247). Among the current CS users, a higher cumulative dose of CS (≥39,725 mg) or longer cumulative use of CS (≥182 days), was significantly associated with an increased risk of developing hypertension. Conclusion: The incidence of CS-associated hypertension is ver y low when using low-dose treatment regimens for AD. However, the current use or a high cumulative dose of CS for treating patients with AD increases the risk of developing hypertension. Precaution is needed when prescribing CS for long-term treatment of AD.

Abstract

Background: Cyclosporine (CS) is a first-line immunosuppressive agent used to manage mod- erate to severe atopic dermatitis (AD). To date, the risk of developing hypertension associated with the long-term use of low-dose CS in AD patients is understudied. Objective: To determine the cumulative dose-dependent effect of CS on the risk of developing hypertension in patients with AD. Methods: A nationwide population-based retrospective cohort with 1,844,009 AD patients was built from the Korean National Health Insurance System database from 2005 to 2009. A Cox proportional-hazard regression analysis was performed according to patients’ CS treatment histor y adjusted for potential confounders. Results: Current use of CS was associated with an increased risk of developing hypertension (adjusted hazard ratio, 4.442; 95% confidence inter val, 3.761–5.247). Among the current CS users, a higher cumulative dose of CS (≥39,725 mg) or longer cumulative use of CS (≥182 days), was significantly associated with an increased risk of developing hypertension. Conclusion: The incidence of CS-associated hypertension is ver y low when using low-dose treatment regimens for AD. However, the current use or a high cumulative dose of CS for treating patients with AD increases the risk of developing hypertension. Precaution is needed when prescribing CS for long-term treatment of AD.

참고문헌 (40)

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