在巴西结核病治疗期间对药物不良反应的预测模型
Felipe Ridolfi1,2, Gustavo Amorim3, Lauren S Peetluk4,5
1Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
The Journal of infectious diseases
|January 23, 2024
概括
预测结核病 (TB) 治疗药物不良反应 (TB-ADRs) 是至关重要的. 使用临床因素或NAT2配置文件的模型准确预测TB-ADRs,改善患者的坚持和结果.
科学领域:
- 药监和药物安全 药监和药物安全
- 传染病流行病学 传染病流行病学
- 临床预测建模临床预测建模
背景情况:
- 与结核病 (TB) 治疗相关的不良药物反应 (TB-ADRs) 对治疗的坚持和成功构成重大挑战.
- 识别患有结核病ADRs高风险的患者对于主动管理至关重要.
研究的目的:
- 在药物敏感肺结核患者中开发和验证TB-ADRs的预测模型.
- 确定结核病-ADRs的主要临床和遗传预测因子.
主要方法:
- 开发了使用启动后向选择和考克斯回归的预测模型.
- 包括基线预测因素,如同时服用药物 (CM),艾滋病毒状态,HbA1c,年龄,BMI和NAT2乙化剂配置文件.
- 评估结核病-ADRs的因果关系,器官系统和等级,由主治医生确定.
主要成果:
- 945名参与者中有102人 (11%) 发生了156例TB-ADR;大多数是肝病和中度重症.
- 一个包括CM使用,HbA1c,酒精使用,艾滋病毒阳性,BMI和年龄在内的主要模型显示出强大的预测性能 (c-统计 = 0.79).
- 艾滋病病毒阳性 (HR, 2.68) 和CM使用 (HR, 5.26) 是结核病ADRs的重要风险因素.
结论:
- 开发了结合临床变量或NAT2配置文件的预测模型,对预测TB-ADRs非常有效.
- 这些模型可以帮助临床医生识别有风险的个体,从而有可能改善结核病治疗结果.
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