对于与肺部疾病相关的肺高血压患者的selexipag:一项初步研究
Kazuya Yoshikawa1, Osamu Nishiyama1, Ryo Yamazaki1
1Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, 377-2 Onohigashi, Osakasayama, Osaka, 589-8511, Japan.
塞列西巴格在治疗肺部疾病 (PH-LD) 的肺高血压方面显示出潜力,一半的患者反应良好. 较高的BMI和较低的氧气水平可能预示着对这种PH-LD治疗的良好反应.
科学领域:
- 肺部病理学 肺部病理学
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 肺动脉高血压 (PAH) 特定的疗法通常对与肺部疾病 (PH-LD) 相关的肺动脉高血压无效.
- 对于PH-LD的治疗选择有限,需要探索替代治疗策略.
- 一种前环素受体对抗剂Selexipag已被批准用于PAH,但其在PH-LD中的有效性尚未得到充分证实.
研究的目的:
- 评估selexipag在被诊断为PH-LD的患者中的潜在疗效.
- 评估selexipag对血液动力学参数,6分钟步行距离 (6MWD) 和PH-LD中的气体交换的影响.
- 在PH-LD.中确定对selexipag治疗反应的潜在预测因子.
主要方法:
- 在2016年10月至2019年3月期间连续接受selexipag治疗的PH-LD患者的回顾性评估.
- 在治疗前和治疗后评估血液动力学参数,6MWD和氧气部分压力/吸入氧气分数 (PaO2/FiO2).
- 将响应者定义为6MWD改善≥20米的患者.
主要成果:
- 包括8名PH-LD患者 (4名COPD,3名ILD,1名朗格汉斯细胞囊炎).
- 没有观察到总体血液动力学参数或6MWD的统计显著改善.
- 四名患者 (50%) 符合应答者标准 (≥20m 6MWD改善). 与非响应者相比,受试者具有较高的基线BMI和较低的基线PaO2/FiO2 (分别为p=0.02和p=0.04).
- 在selexipag治疗期间没有报告3级或4级不良事件.
结论:
- 在评估的PH-LD患者中,Selexipag在约一半的患者中显示出潜在的疗效.
- 较高的基线BMI和较低的基线PaO2/FiO2可能表明PH-LD中对selexipag的良好反应.
- 开始用低剂量和定位的Selexipag可以被认为是PH-LD的潜在治疗选择,这需要进一步的大规模调查.
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