奥塞杜伦的有效性和安全性:BLOCK-CKD研究的子组分析
George L Bakris1, Y Fred Yang2, James M McCabe2
1Department of Medicine, American Heart Association Comprehensive Hypertension Center, The University of Chicago Medicine, Chicago, Illinois, USA.
American journal of hypertension
|July 20, 2023
概括
奥塞杜伦能有效地降低慢性病患者的血压,包括西班牙裔患者和糖尿病患者在内的各种亚组. 该药物表现出一致的疗效和安全性,没有报告严重的高血病事件.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 奥塞杜伦 (KBP-5074) 是一种非类固醇矿物质皮质类受体对抗剂,研究用于慢性病 (CKD) 中的高血压.
- 之前的研究 (BLOCK-CKD) 显示,ocedurenone可以降低抗高血压的3b/4阶段CKD的血压 (BP).
- 在特定小组 (西班牙裔,第四阶段CKD,糖尿病,高白蛋白尿) 中的有效性和安全性以前没有报告.
研究的目的:
- 分析Ocedurenone在降低特定患者亚组内的缩血压 (SBP) 的疗效.
- 评估Ocedurenone的安全性,重点关注血清水平,在这些子组.
主要方法:
- 对来自BLOCK-CKD研究 (n=162) 的数据进行了子组分析.
- 主要终点:从基线到第84天的SBP变化.
- 分析的子组:种族 (西班牙裔),CKD阶段 (4阶段),糖尿病和白尿水平.
- 安全性分析的重点是血清的变化.
主要成果:
- 与安慰剂相比,ocedurenone在所有分析的子组中始终降低了SBP.
- 在西班牙裔患者,患有CKD第四阶段,糖尿病和非常高的白蛋白尿症患者中观察到与安慰剂调整后显著的SBP减少.
- 血清水平在各亚组显示出相似的,轻微的升高,没有需要干预或停止治疗的高血症.
结论:
- 在各种CKD患者亚组中,ocedurenone表现出一致的SBP降低功效.
- 矿物质皮质类受体抗剂是安全的,耐受性很好,即使在糖尿病患者或高albuminuria.
- 没有Ocedurenone相关的高血症事件需要改变治疗或取消研究.
更多相关视频
相关概念视频
Heart Failure Drugs: β-Blockers
364
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
364
Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers
773
Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which...
773
Depolarizing Blockers: Pharmocokinetics
353
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
353
Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers
1.1K
Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
1.1K
Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers
1.5K
Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
1.5K
Depolarizing Blockers: Mechanism of Action
1.6K
Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...
1.6K


