药物诱导的渐进性多焦点白内障 (PML):系统性审查和元分析
Lorenzo Vittorio Rindi1, Drieda Zaçe1, Neva Braccialarghe1
1Department of Systems Medicine, Tor Vergata University, Via Montpellier, 1, 00133, Rome, Italy.
Drug safety
|February 6, 2024
概括
渐进性多焦点白内障 (PML) 的风险因药物而异,纳塔利祖马布在多发性硬化症 (MS) 患者中具有最高风险. 与标准剂量相比,纳塔利祖马布的延长剂量间隔可能会降低PML发病率.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 渐进性多焦点白血脑病 (PML) 的发病率已经从艾滋病毒/恶性瘤患者转移到免疫调节/向疗法患者.
- 本综述评估了与药物相关的PML风险和发病率,不包括艾滋病毒,原发性免疫缺陷或恶性瘤.
研究的目的:
- 系统地审查和元分析药物诱导PML的发病率.
- 确定哪些免疫调节药物最常与PML发展有关.
主要方法:
- 系统审查和103项研究的元分析,截至2022年5月.
- 包括80岁以下的患者,不包括艾滋病毒,原发性免疫缺陷或恶性瘤.
- 每100人中计算的PML发病率和分析的观察时间.
主要成果:
- 对于ocrelizumab, vedolizumab和其他几种药物,没有报告PML病例.
- 达尔法姆普里丁,格拉蒂拉默酸盐,二甲基烟酸和芬戈利莫德显示出相对安全的特征.
- 对多发性硬化症 (MS) 的纳塔利祖马布治疗显示PML发病率为0.33例/100人;延长间隔剂量 (EID) 的风险较低 (0.08) 比标准间隔剂量 (SID) (0.3).
结论:
- 神经学领域显示,与药物相关的PML风险更高,特别是在MS的长期纳塔利祖马布治疗中.
- 虽然纳塔利祖马布在MS复发中有效,但可以考虑更安全的替代品.
- 风险分层和监测对于免疫调节药物疗法至关重要.
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