选择性血管扩张剂在肺动脉高血压中的长期疗效:使用自发报告数据库进行全面比较
Koji Suzuki1, Tatsuya Yagi2, Junichi Kawakami2
1Department of Hospital Pharmacy, Hamamatsu University School of Medicine, 1-20-1 Handayama, Chuo-Ku, Hamamatsu, 431-3192, Japan. kojisuzu@hama-med.ac.jp.
Naunyn-Schmiedeberg's archives of pharmacology
|January 5, 2024
概括
这项研究使用了日本不良药事件报告数据库来分析肺动脉高血压 (PAH) 药物存活率. 埃波醇和马西坦改善了PAH患者的存活率,而西尔迪纳菲尔与更差的预后有关.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
- 生物统计学 生物统计学
背景情况:
- 关于肺动脉高血压 (PAH) 药物之间长期生存差异的临床数据有限.
- 自发报告数据库为像PAH这样的罕见疾病提供了潜在的,尽管有限的信息来源.
研究的目的:
- 评估日本不良药物事件报告 (JADER) 数据库对比肺血管扩展效应对长期PAH患者存活率的有用性.
- 为了确定特定的药物关联与改善或恶化PAH患者的长期结果.
主要方法:
- 从JADER数据库中获取了PAH患者的数据 (2004年4月~2022年7月).
- 使用卡普兰-梅尔曲线进行生存时间比较.
- 利用考克斯的比例危险模型来确定所有原因死亡率的调整危险比率 (aHR).
主要成果:
- 埃波醇 (向前环素途径) 显示了与长期存活的最强相关性 (aHR,0.38).
- 内甲素受体对抗剂,特别是macitentan,与改善的存活率 (aHR,0.30) 有关.
- 西尔德纳菲尔与更差的预后有关 (aHR,1.56).
结论:
- 尽管存在固有的局限性,但JADER数据库可以为PAH等罕见疾病的生存提供宝贵的见解.
- 特定的肺血管扩张剂对长期PAH患者的生存有不同的影响.
- 需要进一步的研究来验证自发报告系统的这些发现.
相关概念视频
Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors
158
Phosphodiesterase 5 (PDE5) inhibitors are potent enzymes that function to hydrolyze cyclic nucleotides to their corresponding 5' monophosphates. Their unique biochemical properties have been applied in treating Pulmonary Arterial Hypertension (PAH).
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
158
Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
183
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
183
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
166
Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
166
Antihypertensive Drugs: Vasodilators
528
Vasodilators, primarily affecting the smooth muscles within arterial and venous walls, are commonly used for hypertension treatment. Medications such as minoxidil and hydralazine primarily target arteries and arterioles, while sodium nitroprusside acts on arterioles and venules. Minoxidil, functioning as a prodrug, is metabolized by hepatic sulfotransferase into its active form, minoxidil sulfate, after oral administration. This metabolite binds to the sulfonylurea receptor (SUR) component of...
528
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
433
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
433
Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
168
Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
168


