揭开bempedoic酸和痛风之间的关系:来自系统文献综述的结果
Alessia Alunno1, Francesco Carubbi1, Elena Campanozzi1
1Department of Clinical Medicine, Life, Health & Environmental Sciences, Internal Medicine and Nephrology Division, ASL1 Avezzano-Sulmona-L'Aquila, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.
孟佩多酸 (BA) 可能会增加血清尿酸 (SUA) 和痛风风险,但数据有限. 仔细的患者评估和尿酸降低疗法可能会减轻这些风险在患者治疗的bempedoic 酸.
科学领域:
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 班佩多酸 (BA) 是一种新型ATP酸酶抑制剂,用于治疗他类药物不耐受患者的高脂血症.
- 在接受BA.的患者中观察到血清尿酸 (SUA) 升高和痛风发病率增加.
- 本系统性审查评估了BA关于SUA水平和痛风风险的安全概况.
研究的目的:
- 系统地审查随机对照试验 (RCT),调查bempedoic acid (BA) 治疗与血清尿酸 (SUA) 水平之间的关联.
- 评估与安慰剂或其他降脂疗法相比,接受BA治疗的患者中痛风的发病率.
- 确定BA相关的高尿血和痛风的潜在风险因素和缓解策略.
主要方法:
- 截至2023年5月4日,对7个数据库进行了全面搜索.
- 包括BA单独治疗或与其他降脂疗法 (LLTs) 结合在LDL-c升高的患者中的RCT.
- 数据提取由两个独立的审稿人进行,分歧通过协商一致解决.
主要成果:
- 分析了6个第三期和9个第二期RCT (共17975名患者) 的数据.
- 在某些第三期试验中,BA组的高尿路血症发病率高于安慰剂 (1.9%-5.6%),而BA组的发病率高于 (4.9%-11%).
- 虽然一些RCT报告了BA的痛风发病率增加,但效应大小通常很小,在统计学上并不显著;关于SUA升高效应的数据仍然有限.
结论:
- 目前从第二阶段和第三阶段的RCT中获得的数据并不能最终确定BA和痛风之间的强烈关联.
- 对于开始BA治疗的患者,建议对SUA水平和痛风病史进行仔细的基线评估.
- 同时使用尿酸降低剂可能有助于降低BA治疗患者新发痛风或痛风爆发的风险.
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