对心血管疾病的多药剂的使用和迄今为止的证据
Mark D Huffman1, Denis Xavier2, Pablo Perel3
1Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Lancet (London, England)
|March 15, 2017
概括
多种药物或多种药物在一个药物中, 通过改善粘附性和降低风险因素, 显示有望预防动脉样硬化. 需要进一步的研究来证实它们对临床结果的影响,并指导实施.
科学领域:
- 心血管医学
- 药理学
- 公共卫生
背景情况:
- 多种药物已在30多个国家获得批准,但与其他疾病的固定剂量组合相比,其全球使用和数据有限.
- 它们在动脉样硬化预防中的应用需要进一步的研究和临床指导.
研究的目的:
- 建议在未来的研究和临床实践中使用多种药物的指南.
- 综合多种药物预防动脉样硬化的证据,考虑不同群体和适用情况.
主要方法:
- 对32个国家的9059名参与者进行的13项多药试验进行了审查.
- 按人群使用多种药物的分类 (二次预防,高风险的初级预防,群体治疗) 和适应症 (启动,升级,替代).
主要成果:
- 多种药丸通常可以改善药物坚持和耐受性.
- 它们有效地降低了心血管风险因素水平,尽管异质性影响了确定性.
- 与标准治疗相比,目前的试验没有显示出显著的临床结果差异.
结论:
- 多种药丸治疗是减少动脉样硬化过早死亡的潜在可扩展策略.
- 改善遵守和获取是关键的好处,但需要进一步的数据和临床经验才能实现最佳实施.
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