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在初级失眠中使用不同剂量的双素受体对抗剂:贝叶斯网络分析
Tao Xue1, Xin Wu2,3, Jiaxuan Li2
1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Frontiers in pharmacology
|June 1, 2023
概括
这一元分析比较了对失眠的双素受体抗剂 (DORAs). 苏沃雷克桑 (suvorexant),达里多雷克桑 (daridorexant) 和莱博雷克桑 (lemborexant) 在改善睡眠方面表现出有效性,在临床使用时建议使用特定剂量.
科学领域:
- 药理学 药理学是指药理学的学科.
- 睡眠医学 睡眠医学
- 临床试验 临床试验
背景情况:
- 对于FDA批准的双素受体对抗剂 (DORA) 剂量在治疗失眠方面存在有限的系统比较.
- 素受体对抗剂代表了治疗睡眠障碍的关键治疗类.
研究的目的:
- 系统地比较不同剂量的FDA批准的DORA治疗失眠的疗效和安全性.
- 在临床实践中为DORA选择提供基于证据的建议.
主要方法:
- 在PubMed,Embase,Cochrane图书馆和ClinicalTrials.gov的系统文献搜索到2022年10月.
- 包括9个随机对照试验 (RCT),涉及7257名参与者.
- 使用网络元分析信心 (CINeMA) 框架评估证据确定性.
主要成果:
- 苏沃雷克桑 (20,40毫克) 和达里多雷克桑 (10,50毫克) 在减少持续睡眠 (LPS) 的延迟方面表现出高效.
- 伦博雷克桑 (5,10毫克) 在主观睡眠开始时间 (sTSO) 和主观睡眠开始后的觉醒时间 (sWASO) 中最有效.
- 与安慰剂相比,较高剂量的苏沃雷克桑和达里多雷克桑与增加的安全风险有关.
结论:
- 苏沃雷克桑20毫克,莱博雷克桑5毫克,莱博雷克桑10毫克和达里多雷克桑50毫克被确定为有效的失眠治疗选择.
- 这些发现支持基于特定睡眠参数和安全考虑的个性化DORA选择.
- 进一步的研究可能会在不同的失眠人群中完善DORA的最佳剂量策略.
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