比较接受 BRAF 抑制剂的皮肤黑色素瘤或肺癌患者与接受免疫检查点抑制剂 (ICIs) 或传统细胞毒性化疗的患者非感染性葡萄膜炎的发生率。全国人群回顾性临床队列研究方法：来自健康保险评论和韩国评估服务数据库中，我们回顾性定义了 77,323 例接受 BRAF 抑制剂治疗（BRAF 抑制剂暴露组；n=396）、ICIs（ICI 暴露组；n=22,474）或常规治疗的皮肤黑色素瘤或肺癌患者。细胞毒性化疗（未暴露组；n=54,453）。我们计算了从BRAF抑制剂、ICI或细胞毒剂给药第一天起各组非感染性葡萄膜炎的1年累积发生率。在治疗开始的第一年，葡萄膜炎的累积发生率分别为0.33%、0.35%和未暴露组、ICI 暴露组和 BRAF 抑制剂暴露组分别为 2.27%。调整后的风险比 (aHR) 表明，与未暴露组和 ICI 暴露组相比，BRAF 抑制剂暴露组发生葡萄膜炎的风险增加了 7.52 倍和 5.68 倍（95% 置信区间 [CI] 3.83-14.75，P < 0.001 和 95% CI 分别为 2.81-11.47，P < 0.001）。经过1:4倾向评分匹配后，aHR显示葡萄膜炎和严重葡萄膜炎的风险分别增加了35.51倍和15.80倍（95% CI 4.49-280.48，P=0.001和95% CI 1.76-141.00，P=0.014） ，在暴露于 BRAF 抑制剂的患者与未暴露的患者中。 BRAF 抑制剂暴露组内的交叉分析显示，与索引日期前 1 年相比，索引日期后 1 年葡萄膜炎风险增加 3.71 倍（95% CI 1.03-13.40，P=0.046）。在 BRAF 抑制剂暴露组中，女性、慢性肾病和黑色素瘤与葡萄膜炎风险增加（尽管不显着）的趋势相关。接受 BRAF 抑制剂治疗的黑色素瘤或肺癌患者的非感染性葡萄膜炎风险显着高于其他患者用传统的细胞毒性药物或 ICI 治疗。这些发现强调了治疗前患者对 BRAF 抑制剂相关葡萄膜炎风险进行教育的重要性，以便在给药期间出现症状时能够及时进行眼科评估和治疗。版权所有 © 2024。由 Elsevier Inc. 出版。

To compare the incidence of noninfectious uveitis in skin melanoma or lung cancer patients who received BRAF inhibitors with that in those who received immune checkpoint inhibitors (ICIs) or conventional cytotoxic chemotherapy.Nationwide population-based retrospective clinical cohort study METHODS: From the Health Insurance Review and Assessment Service database of South Korea, we retrospectively defined 77,323 patients with skin melanoma or lung cancer who received BRAF inhibitor therapy (BRAF inhibitor-exposed group; n = 396), ICIs (ICI-exposed group; n = 22,474), or conventional cytotoxic chemotherapy (unexposed group; n = 54,453). We calculated the 1-year cumulative incidence of noninfectious uveitis in each group from the first day of BRAF inhibitor, ICI, or cytotoxic agent administration.During the first year of treatment initiation, the cumulative incidence of uveitis was 0.33%, 0.35%, and 2.27% in the unexposed, ICI-exposed, and BRAF inhibitor-exposed groups, respectively. Adjusted hazard ratios (aHR) indicated a 7.52-fold and 5.68-fold increased risk of uveitis in the BRAF inhibitor-exposed group compared with that in the unexposed and ICI-exposed groups (95% confidence interval [CI] 3.83-14.75, P < 0.001 and 95% CI 2.81-11.47, P < 0.001, respectively). After 1:4 propensity score matching, aHRs showed a 35.51-fold and 15.80-fold increased risk (95% CI 4.49-280.48, P = 0.001 and 95% CI 1.76-141.00, P = 0.014) of uveitis and severe uveitis, respectively, in the BRAF inhibitor-exposed versus unexposed patients. Crossover analysis within the BRAF inhibitor-exposed group showed a 3.71-fold increase in uveitis risk during 1-year post index date in comparison with 1-year prior to index date (95% CI 1.03-13.40, P = 0.046). In the BRAF inhibitor-exposed group, female sex, chronic kidney disease, and melanoma were associated with a trend of increased, albeit nonsignificant, risk of uveitis.Melanoma or lung cancer patients treated with BRAF inhibitors showed significantly higher risk of noninfectious uveitis than patients treated with conventional cytotoxic drugs or ICIs. These findings emphasize the importance of pretreatment patient education on BRAF-inhibitor-associated uveitis risk to enable prompt ophthalmic evaluation and treatment if symptoms arise during drug administration.Copyright © 2024. Published by Elsevier Inc.