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在肥胖中改变药物处置的临床后果:呼吁改变
Christopher D Bruno1,2, David J Greenblatt1,3, Jerold S Harmatz1
1Program in Pharmacology and Drug Development, Tufts University School of Medicine, Boston, MA, USA.
Journal of clinical pharmacology
|November 9, 2023
概括
肥胖需要量身定制的药物剂量. 本次审查强调需要针对肥胖症的剂量策略,特别是对于半衰期较长的药物,使用体重指数指导调整.
科学领域:
- 药理学和治疗学 药理学和治疗学
- 肥胖医学 肥胖医学
- 药物开发 药物开发
背景情况:
- 肥胖是一个日益严重的全球健康问题,伴随着许多相关的健康风险.
- 肥胖人口中药物处置和剂量研究不足,导致临床指导有限.
- 目前针对肥胖症的剂量调整主要针对药物清除的改变,并且通常不基于专门的研究.
研究的目的:
- 审查当前使用身体测量在肥胖患者慢性药物剂量使用的实践.
- 强调针对肥胖症的剂量说明的必要性,特别是由于分发量增加而延长半衰期的药物.
- 为了确定特定的药物,身体质量指数 (BMI) 可以指导剂量调整,如升级,加载或冲洗.
主要方法:
- 对当前肥胖药物剂量实践的文献综述.
- 对肥胖症中药物动力学变化相关的药物处置原理的分析.
- 鉴定具有潜在的BMI导向剂量策略的药物 (沃蒂奥克塞丁,波萨科纳,布雷克斯皮普拉).
主要成果:
- 对于肥胖的现有剂量指南往往是有限的,而不是针对肥胖的.
- 在肥胖个体中半衰期延长的药物可以从量身定制的剂量策略中受益.
- 西,波萨可纳和布雷克斯皮普拉是BMI可以为剂量调整提供信息的例子.
结论:
- 在临床药物研究中,有必要将肥胖个体作为一个独特的子群体纳入临床药物研究.
- 应使用体重指数 (BMI) 来指导肥胖患者的药物剂量决定.
- 制定针对肥胖症的剂量策略对于优化该群体中药物的有效性和安全性至关重要.
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