持续性心炎复发风险降低 长期使用Rilonacept
Massimo Imazio1, Allan L Klein2, Antonio Brucato3
1Department of Medicine (DMED), University of Udine and Cardiothoracic Department University Hospital Santa Maria della Misericordia, ASUFC Udine Italy.
Journal of the American Heart Association
|March 12, 2024
概括
在RHAPSODY长期扩展中,持续的rilonacept治疗有效地管理了复发性心膜炎. 在18个月后暂停治疗增加了心膜炎复发的风险,突出显示了持续抑制白内素-1的重要性.
科学领域:
- 心脏病学 心脏病学
- 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:
- 再发性心膜炎是一个重大的临床挑战.
- 在RHAPSODY第3阶段研究中,一种介质素-1陷的rilonacept在减少心膜炎复发方面表现出有效性.
- 拉普索迪长期扩展研究了持续治疗及其对疾病自然史的影响.
研究的目的:
- 评估 rilonacept 在患有复发性心膜炎的患者的长期疗效和安全性.
- 探索治疗持续时间的决策及其与心膜炎复发的关联.
- 评估持续的瑞洛纳塞普治疗与暂停对复发率的影响.
主要方法:
- 来自RHAPSODY研究的74名患者进入了长期延期治疗.
- 患者接受了开放标签的 rilonacept,长达 24 个月.
- 治疗决定 (继续,暂停或停止rilonacept) 在复发后的18个月里程碑时做出.
主要成果:
- 与研究前率 (4,4事件/患者年) 相比,rilonacept的年度复发率显著较低 (0.04事件/患者年).
- 在18个月的里程碑,64%的患者继续服用里洛纳塞普,15%暂停服用,21%停止服用.
- 与暂停治疗 (HR=0.02,P<0.0001) 的患者相比,继续服用里洛纳塞普的患者患病复发的风险降低了98%.
结论:
- 持续的利洛纳塞普特治疗与持续的反应和复发性心周炎的低复发率有关.
- 在18个月的决策点暂停治疗与心膜炎复发的更高发病率有关.
- 持续使用里洛纳塞普特抑制介质素-1对于治疗复发性心膜炎至关重要.
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