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肥胖患者的阿皮克萨班血度
Fadiea Al-Aieshy1, Mika Skeppholm2, Jonas Fyrestam3
1Department of Medicine Solna, Karolinska Institutet & Clinical Pharmacology, Karolinska University Hospital Solna, 17176, Stockholm, Sweden. fadiea.al-aieshy@ki.se.
European journal of clinical pharmacology
|June 1, 2024
概括
在肥胖患者中对阿皮克萨班的治疗药物监测显示,低谷度略高,但与正常体重个体相比,峰值水平相似. 肥胖患者的高变化表明个性化监测可能是有益的.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床药房 临床药房
- 内部医学 内部医学
背景情况:
- 对阿皮克萨班的常规治疗药物监测 (TDM) 并不是标准实践.
- 有限的数据存在于各种患者群体的阿皮克萨班度,包括那些肥胖患者.
- 确定可能从阿皮克萨班TDM中受益的患者群体对于优化治疗至关重要.
研究的目的:
- 为了研究和比较肥胖患者和正常体重患者的阿皮克萨班暴露.
- 评估这些组之间阿皮克萨班药理动学的潜在差异.
主要方法:
- 一项研究包括40名肥胖患者 (平均BMI为39.4 kg/m2) 和40名正常体重的对照患者 (平均BMI为23.4 kg/m2).
- 参与者每天两次服用阿皮克萨班5毫克,并根据年龄,性别和功能进行匹配.
- 使用液体染色学-并联质谱法 (LC-MS/MS) 量化了阿皮克萨班的低度和峰值度.
主要成果:
- 与正常体重对照组 (52.0 ng/ml) 相比,肥胖患者 (58.7 ng/ml) 的中位数阿皮克萨班度略微升高 (p < 0.05).
- 在肥胖组中观察到低谷度的显著更高的个体间变异性.
- 在肥胖 (124.5 ng/ml) 和正常体重 (113.5 ng/ml) 患者中,阿皮克萨班的平均峰值度是可比的.
结论:
- 在肥胖患者和正常体重患者之间,阿皮克萨班的暴露没有显著差异,这表明例行剂量调整是不必要的.
- 肥胖患者中阿皮克萨班度的显著个体间变异性表明,对精选个体的治疗药物监测具有潜在价值.
- 需要进一步的研究,以确定肥胖人口中的特定患者亚组,这些患者将从阿皮克萨班度监测中获益最多.
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