在普拉斯莫迪活疟疾的原始治疗中发生严重血解:两个系统性审查和个体患者数据描述性分析
Daniel Yilma1,2,3, Emily S Groves4, Jose Diego Brito-Sousa5,6
1Jimma University Clinical Trial Unit, Department of Internal Medicine, Jimma University, Jimma, Ethiopia.
The American journal of tropical medicine and hygiene
|August 21, 2023
概括
普里马奎因 (PQ) 可以导致严重的血解在患有葡萄糖-6-酸盐脱酶 (G6PD) 缺乏的人. 加强监测和明确的定义对于管理疟疾患者的PQ相关血液溶解至关重要.
科学领域:
- 药物监督 药物监督 药物监督
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
背景情况:
- 普里马奎因 (PQ) 对于根除Plasmodium vivax hypnozoites至关重要,但在缺乏葡萄糖-6-酸盐脱酶 (G6PD) 的个体中存在严重血解的风险.
- 现有的关于PQ相关血解及其管理的数据是分散的,需要进行系统的审查.
研究的目的:
- 系统地审查与PQ治疗vivax疟疾相关的血液严重不良事件 (SAE) 的定义和频率.
- 描述严重的PQ相关血液溶解需要住院治疗的临床表现,管理和结果.
主要方法:
- 进行了两项系统性审查:一项分析了与PQ相关的SAE的临床试验数据,另一项检查了与PQ相关的严重血液溶解的前性研究和病例报告.
- 数据提取的重点是SAE定义,发病率,临床特征,治疗和结果,包括G6PD状态和死亡率.
主要成果:
- 第一次审查确定了不同的SAE定义,在9,824名接受PQ治疗的患者中发现了34例血液学SAE,其中9例需要住院治疗或输血.
- 第二次审查分析了163名住院患者,其中96.8%的G6PD缺乏;严重的血液溶解症状通常出现在2-3天,7名患者 (6.9%) 死亡.
- 大多数住院患者接受了与推剂量相等或超过的PQ,这凸显了即使使用可用的G6PD测试也需要谨慎.
结论:
- 严重的PQ相关血液溶解是一个显著的风险,特别是在G6PD缺乏的个体中,需要加强监测和标准化定义.
- 建议在PQ治疗开始后五天内进行早期临床检查,以便及时检测和管理血液溶解.
- 需要进一步的研究,以建立更强大的定义,并提高PQ激进治疗vivax疟疾的安全性.
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