在接受甲维持治疗的患者中,将甲从甲转换为等效R-甲剂量对QTc间隔的影响
Stine Marie Havig1, Riikka Mari Berg-Pedersen2, Hege-Merete Krabseth1
1Department of Pharmacology, Oslo University Hospital, Oslo, Norway.
在接受甲维持治疗的患者中,切换为R-甲减少了纠正的QT (QTc) 间隔,但这种减少小于临床相关. 这表明R-甲可能为管理QTc延长提供更安全的替代方案.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 已知阿片类药物使用障碍的常见治疗方法甲会延长QT间隔,增加心律不整的风险.
- 与S-甲相比,R-甲对心脏通道的抑制较小,这表明心脏安全性可能有所改善.
研究的目的:
- 评估从赛血甲转换为R-甲对接受甲维持治疗 (MMT) 的患者纠正的QT (QTc) 间隔的影响.
- 为了确定这种开关是否可以将QTc延长减少到临床上相关的程度.
主要方法:
- 一项涉及9名MMT患者的研究,基线QTc间隔≥450毫秒.
- 患者从甲转换为R-甲的等效剂量.
- 电心电图 (ECG) 和血清甲度在切换前和之后 (14日和28日) 的最低 (Cmin) 和最高 (Cmax) 水平测量.
主要成果:
- 切换到R-甲导致Cmin (-8毫秒,p=0.047) 中平均QTc间隔的统计显著减少.
- 观察到的QTc间隔的减少小于预定义的20毫秒,被认为是临床相关的.
- 观察到R-甲水平和QTc间隔之间的度依赖关系.
结论:
- 切换到R-甲可以减少MMT患者的QTc间隔,但这种效果可能在临床上不足以完全减轻QTc延长风险.
- 需要进一步研究更大的样本大小和更长的随访期,以充分评估R-甲在MMT中的长期心脏安全性和疗效.
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