デノスマブまたはアレンドロン酸が大動脈狭窄症の進行に及ぼす影響: 双盲ランダム化比較試験
Tania A Pawade1, Mhairi K Doris1, Rong Bing1
1British Heart Foundation Centre for Cardiovascular Science (T.A.P., M.K.D., R.B., A.C.W., M.C.W., P.D.A., J.P.M.A., T.R.G.C., W.S.A.J., M.S., T.F., N.B., D.E.N., M.R.D.), University of Edinburgh, United Kingdom.
Circulation
|April 29, 2021
まとめ
デノスマブもアレンドロニン酸も,大動脈弁の結石化の進行を遅らせることはありませんでした. この状態に対する効果的な治療法を見つけるにはさらなる研究が必要です.
科学分野:
- 心臓病科
- 生物化学
- 薬理学について
背景:
- 弁のカルシフィケーションは大動脈狭窄の病原性の鍵です.
- 骨の周回と骨質分化が関与するメカニズムです.
- これらの経路を標的とした治療法を研究することが重要です
研究 の 目的:
- デノスマブまたはアレンドロニン酸が大動脈狭窄の進行を抑えるかどうかを判断する.
- バルブカルシフィケーションに対するこれらの薬物の効果を評価する.
- 大動脈狭窄症の 治療法を研究する
主な方法:
- カルシフ性大動脈狭窄症の患者150人を対象としたランダム化比較試験
- 患者はデノスマブ,アレンドロニック酸,またはプラセボを受けた.
- 主なエンドポイントは,CTスキャンとエコーカルディオグラフィで評価された,大動脈弁のカルシウムスコアの24ヶ月の変化でした.
主要な成果:
- デノスマブとアレンドロニン酸は,骨の転移マーカー (血清C端テロペプチド) を効果的に減少させた.
- 薬剤群とプラセボ群の間で24ヶ月の大動脈弁カルシウムスコアの有意な変化は見られなかった.
- 動脈のピークジェット速度の変化と18F-ナトリウムフッ素の吸収も有意な違いを示さなかった.
結論:
- デノスマブとアレンドロニン酸は,大動脈狭窄における大動脈弁のカルシフィケーションの進行を抑制しません.
- 大動脈狭窄に寄与する代替経路は調査が必要です.
- 病気を改変する新しい治療法の開発は この増加する患者集団にとって不可欠です
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