アイゼンメンガー症候群の患者におけるマシテンタンの評価
Michael A Gatzoulis1, Michael Landzberg1, Maurice Beghetti2
1The Royal Brompton Hospital and National Heart & Lung Institute, Imperial College, London, United Kingdom (M.A.G.).
Circulation
|December 28, 2018
まとめ
MAESTRO研究では,アイゼンメンガー症候群患者の運動能力は改善されなかった. このエンドセリン受容体の抗体が16週間の試験でプラセボに比べて有意な効果を示さなかった.
科学分野:
- 心臓病科
- 肺科
- 薬理学について
背景:
- アイゼンメンガー症候群は,右から左にシャントリングした先天性心疾患による重度の肺高血圧を伴う.
- MAESTRO研究では,エンドセリン受容体の抗体であるマシテンタンが,アイゼンメンガー症候群の治療に用いられました.
研究 の 目的:
- アイゼンメンガー症候群の患者の運動能力の改善におけるマシテンタンの有効性と安全性を評価する.
- 機能的クラス,NT-proBNPレベル,および血液動力学に対するマシテンタンの影響を評価する.
主な方法:
- マルチセンター,ダブルブラインド,ランダム化,プラセボ制御,16週間のフェーズIII試験.
- 226人の患者 (12歳以上,WHO機能クラスII-III) は,マシテタン10 mgを1日またはプラセボで投与された.
- 主要評価点: 歩行距離の6分の変化; 副次評価点: WHO機能クラスの変化.
主要な成果:
- マシテンタンは,プラセボと比較して,6分間の歩行距離を有意に改善しなかった (平均差は-4. 7m,P=0. 612).
- グループ間のWHO機能的クラス改善の有意な差は認められなかった (OR0. 53).
- マシテンタンはNT-proBNP濃度と肺血管抵抗指数 (PVRi) を減少させた.
結論:
- マシテンタンは,アイゼンメンガー症候群における運動能力の改善においてプラセボよりも優れていることを示さなかった.
- NT-proBNPやPVRiのような探索的措置で潜在的可能性を示したものの,主要エンドポイントは満たされなかった.
関連する概念動画
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
783
Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
783
01:20Nursing Process for Patient and Caregiver Teaching III: Evaluation and Documentation
2.6K
Evaluation of the teaching process enables the nurse to determine if the patient's learning needs were met and if training was effective. If the expected outcomes are not met, the care plan is revised, and additional education or reinforcement is provided. Nurses can ask questions after the session or obtain feedback to assess the patient's understanding of the topic.
Nurses can use several methods to evaluate patient outcomes. For example, oral questions can assess cognitive learning,...
Nurses can use several methods to evaluate patient outcomes. For example, oral questions can assess cognitive learning,...
2.6K
01:24Nephrotic Syndrome I : Introduction
633
Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of...
633
01:30Acute Coronary Syndrome I: Introduction
990
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
990
01:17Irritable Bowel Syndrome I: Introduction
1.0K
Irritable Bowel Syndrome (IBS) is characterized by functional disturbances in the gastrointestinal system, presenting a cluster of symptoms without evident structural or biochemical abnormalities. It primarily affects the large intestine and may cause abdominal pain, bloating, excessive gas, diarrhea, constipation, or both.
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
1.0K
01:27Restless Leg Syndrome and Night Terrors
560
Restless Leg Syndrome (RLS), also known as Willis-Ekbom disease, is a neurological disorder characterized by an uncontrollable urge to move the legs due to uncomfortable sensations. These sensations typically occur during periods of rest or inactivity, particularly when lying down or sitting, and can severely disrupt sleep.
The exact cause of RLS is not fully understood, but it is believed to involve dopamine, a neurotransmitter that helps regulate muscle movement. Imbalances in dopamine levels...
The exact cause of RLS is not fully understood, but it is believed to involve dopamine, a neurotransmitter that helps regulate muscle movement. Imbalances in dopamine levels...
560