治疗接受易布鲁替尼的高血压患者:一个多中心的回顾性研究
Laura Samples1,2, Jenna Voutsinas1, Bita Fakhri3
1Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA.
Blood advances
|February 5, 2024
概括
布鲁顿氨酸激酶抑制剂 (BTKis) 可以导致高血压 (HTN). 结合β抑制剂和甲酸的联合治疗有利于先前有HTN的患者,而与甲酸结合的ACE抑制剂/ARB则有助于新出现HTN的患者.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 心脏病学 心脏病学
背景情况:
- 布鲁顿氨酸激酶抑制剂 (BTKis) 是对淋巴细胞恶性瘤的有效治疗方法,但可以诱导或加剧高血压 (HTN).
- 与BTKi相关的HTN的最佳管理策略尚不清楚,这对临床医生来说是一个挑战.
- 了解针对不同患者群体有效的特定抗高血压疗法至关重要.
研究的目的:
- 调查不同类别的抗高血压药物在管理BTKi相关的HTN时的有效性.
- 为了比较先前存在HTN的患者和在BTKi启动后发展HTN的患者的治疗结果.
主要方法:
- 对接受BTKis和抗高血压药物的196名淋巴细胞恶性瘤患者的回顾性分析.
- 患者被分为前HTN (BTKi之前诊断的) 和 de novo HTN (BTKi后诊断的).
- 用通用估计方程来评估抗高血压药物类别与平均动脉压 (MAP) 变化之间的关联.
主要成果:
- 患有先前HTN的患者通过β抑制剂 (BBs) 加上化化 (HCTZ) 显著减少了MAP.
- 患有de novoHTN的患者经历了与血管激素转化酶抑制剂 (ACEi) 或血管激素受体抑制剂 (ARBs) 以及HCTZ的显著MAP降低.
- 这些组合疗法也与最高的正常压力MAP率相关.
结论:
- 在BTKis患者中治疗HTN是复杂的,通常需要多种药物抗高血压疗法.
- 特定的组合疗法显示基于HTN发病与BTKi启动的差异性疗效.
- 需要进一步的前性研究来验证这些发现并完善治疗指南.
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