在SIADH中长期低剂量托尔瓦的疗效和安全性
Marta Bondanelli1, Ludovica Aliberti2, Irene Gagliardi2
1Section of Endocrinology, Geriatrics and Internal Medicine, Dept of Medical Sciences, University of Ferrara, Ferrara, Italy. bndmrt@unife.it.
Endocrine
|July 28, 2023
概括
长期低剂量托尔瓦普坦是安全有效的治疗不适当抗尿激素分泌综合征 (SIADH) 相关的低血症. 这种方法避免了过度纠正,并且在慢性SIADH患者中显示出有益的临床效应.
科学领域:
- 内分泌学 在内分泌学.
- 腎臟病學 (nephrology) 是一種醫學.
- 药理学 药理学是指药理学的学科.
背景情况:
- 不适当的抗尿激素分泌综合征 (SIADH) 经常用托尔瓦普坦治疗,托尔瓦普坦是一种血管压素V2受体对抗剂.
- 目前的治疗指南建议每天初始剂量为15毫克,但较低的剂量可能会降低过度校正的风险.
- 在SIADH中低剂量托尔瓦普坦的长期疗效和安全性数据有限.
研究的目的:
- 评估长期使用低剂量托尔瓦普坦 (<15毫克/天) 治疗慢性SIADH的安全性和疗效.
- 为了评估在长期使用低剂量托尔瓦普坦时,过度纠正和其他不良事件的风险.
主要方法:
- 对11名患有慢性SIADH (神经,异常,瘤原因) 的患者进行了回顾性分析,这些患者接受了低剂量托尔瓦普坦 (<15毫克/天) 治疗.
- 在多次间隔的7年内监测血水平.
- 收集临床数据,包括不良事件和患者结局.
主要成果:
- 平均治疗持续时间为27.3个月,在整个随访期 (长达7年) 中,血水平保持在正常范围内.
- 没有观察到透性脱髓化综合征或过度校正的病例.
- 患者的水平正常化,导致改善的临床结果,如发作消失,神经改善和更好的耐受化疗.
结论:
- 低剂量托尔瓦普坦的长期治疗是治疗慢性SIADH的安全有效策略.
- 这种方法成功地使血水平正常化,而没有过度纠正等重大不良事件.
- 观察到的临床改善表明,托尔瓦普坦是SIADH患者的有价值的治疗选择.
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