在 Paroxysmal 夜间血红蛋白尿症的口服伊普塔科潘单疗法
Régis Peffault de Latour1, Alexander Röth1, Austin G Kulasekararaj1
1From the Hematology and Transplant Unit, French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital (R.P.L., F.S.F.), and Université de Paris (R.P.L.), Paris, Centre Hospitalier Universitaire (CHU) de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse (S.T.), and CHU Lille, Université de Lille, Lille (L.T.) - all in France; the Department of Hematology and Stem Cell Transplantation, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen (A.R., F.A.), the Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, University Hospital RWTH Aachen, and the Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, Aachen (J.P.), the University of Ulm, the Institute of Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen, and University Hospital Ulm, Ulm (H.S., B. Höchsmann), the Department of Oncology, Hematology, and Bone Marrow Transplantation, Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg (P. Schafhausen), and Elblandklinikum Riesa, Riesa (J.S.) - all in Germany; King's College Hospital NHS Foundation Trust (A.G.K., S.G., R.T.), the National Institute for Health and Care Research and Wellcome King's Clinical Research Facility (A.G.K.), King's College London (A.G.K.), and Novartis Pharmaceuticals (C.T.), London, and St. James's University Hospital, Leeds (M.G., R.J.K.) - all in the United Kingdom; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing (B. Han, C.Y.), the Department of Hematology, Tianjin Medical University General Hospital (R.F., H.L.), and the Department of Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences (L.Z.), Tianjin, and China Novartis Institutes for BioMedical Research, Shanghai (Z.W., S.L.) - all in China; the Division of Hematology, Hospital A Beneficência Portuguesa, São Paulo (P. Scheinberg), and ABC Medical School, Santo André (V.A.Q.M.) - both in Brazil; the Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland (J.P.M.); Osaka University Graduate School of Medicine, Suita (Y.U.), Kyoto University Hospital, Kyoto (T.K.), and Japanese Red Cross Society Suwa Hospital, Suwa (M.U.) - all in Japan; Duke University School of Medicine and Duke Cancer Institute, Durham, NC (C.M.C.); Unità Operativa Complessa Oncoematologia, AULSS7 Pedemontana, Bassano del Grappa (E.D.B.), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (W.B.), Division of Hematology, University of Turin, Città della Salute e della Scienza, Turin (E.B.), Instituto per lo Studio, la Prevenzione e la Rete Oncologica, and Azienda Ospedaliero-Universitaria Careggi, Florence (R.N.), AORN Moscati, Avellino (L.M., A.M.R.), and University of Naples Federico II, Naples (A.M.R.) - all in Italy; Radboud University Medical Center, Nijmegen, the Netherlands (S.M.C.L.); the Hematology Unit, Department of Medicine, Hospital Umum Sarawak, Kuching (L.P.C.), and the Hematology Unit, Queen Elizabeth Hospital, Kota Kinabalu (L.W.L.L.) - both in Malaysia; Hospital Clinic of Barcelona (A.G.) and the Severe Aplastic Anemia Working Party of the European Society for Blood and Marrow Transplantation (R.P.L., A.G.K., M.G., W.B., S.T., L.T., F.S.F., L.M., A.M.R.) - both in Barcelona; the Department of Hematology and Oncology and the Department of Clinical Pathology, Hualien Tzu Chi Hospital, the Buddhist Tzu Chi Medical Foundation, and the Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan (W.-H.H.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (J.H.J.); Medical College of Georgia, Augusta (A.K.); City of Hope Medical Center, Duarte, CA (V.P.); the Department of Laboratory Medicine, National University Hospital, Singapore (E.-S.Y.); Novartis Pharma (C.K., R.L., M.D.) and Novartis BioMedical Research (A.V.) - both in Basel, Switzerland; and Novartis Healthcare Private, Hyderabad, India (P.B., R.K., S.M.).
伊普塔科潘是一种口服的B因子抑制剂,通过提高血红蛋白水平,有效治疗阴性夜间血红蛋白尿症 (PNH). 这种口服治疗为患有持续性贫血的患者提供了抗C5治疗的优越替代方案.
科学领域:
- 血液学 血液学 血液学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 透性夜间血红蛋白尿 (PNH) 带来了持续的血液溶解性贫血和有限的口服治疗选择的挑战,特别是对于以前接受过抗C5治疗或尚未服用补充抑制剂的患者.
- 伊普塔科潘是一种新的口服B因子抑制剂,它向与PNH病变有关的补充系统的关键组成部分.
研究的目的:
- 评估IPTACOPAN单一治疗在PNH和持久性贫血患者中的疗效和安全性.
- 在一小组患者中,将伊普塔科潘与标准抗C5疗法进行比较.
- 评估之前没有服用补充剂抑制剂的PNH患者的伊普塔科班.
主要方法:
- 在24周内进行了两项3期临床试验.
- 试验1:在接受抗C5治疗的患者中,随机比较iptacopan与继续抗C5治疗.
- 试验2:对以前没有服用补充剂抑制剂的患者,LDH水平升高的单组评估.
主要成果:
- 在第一项试验中,与抗C5疗法相比,伊普塔科潘显著改善了血红蛋白水平,更高比例的患者在不输血的情况下达到目标血红蛋白.
- 在第二个试验中,大多数接受伊普塔科潘的补充抑制剂原始患者在没有输血的情况下实现了显著的血红蛋白增加.
- 伊普塔科潘治疗导致乳酸脱酶 (LDH),网红细胞和胆红素水平降低,这表明血管内血液溶解减少. 头痛是最常见的不良事件.
结论:
- 伊普塔科潘在抗C5治疗的持久性贫血PNH患者中显示出比抗C5治疗更高的疗效.
- 伊普塔科潘是一种有效的口服治疗选择,用于那些没有接受过补充抑制剂治疗的PNH患者.
- 伊普塔科潘改善了PNH患者的血液学和临床结果,提供了一个有前途的新治疗途径.
相关概念视频
Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:


