在实体器官移植后使用的elexacaftor-tezacaftor-ivacaftor
Siddhartha G Kapnadak1, Kathleen J Ramos
1Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA.
Current opinion in pulmonary medicine
|July 31, 2024
概括
埃尔克萨卡夫托尔-特萨卡夫托尔-伊瓦卡夫托尔 (ETI) 对非肺移植受体患有囊性纤维化有好处,但风险和药物相互作用需要仔细考虑,特别是在肺移植患者中. 需要进一步的研究,以实现移植后的最佳使用.
科学领域:
- 药理学 药理学是指药理学的学科.
- 移植医学 移植医学
- 肺部病理学 肺部病理学
背景情况:
- 囊性纤维化治疗已经通过elexacaftor-tezacaftor-ivacaftor (ETI) 取得了进展.
- ETI针对囊性纤维化中潜在的蛋白质缺陷,改善肺和非肺症状.
- 移植接受者被排除在最初的ETI试验之外,这引发了对其在这个人群中的安全性和有效性的质疑.
研究的目的:
- 审查关于在实体器官移植接受者中使用ETI的现有文献.
- 评估ETI的安全性和有效性,重点关注与免疫抑制剂的潜在药物相互作用.
- 评估ETI在肺部和非肺部移植接受者中患有囊性纤维化症的益处和风险.
主要方法:
- 审查最近的出版物和现实世界的证据在ETI使用移植后.
- 分析ETI与免疫抑制药物 (如塔克罗利斯) 之间报告的药物相互作用.
- 对肺和非肺移植受体的不良事件和临床结果的评估.
主要成果:
- 在非肺移植接受者中,ETI证明了对肺的益处,尽管不良事件可能会影响移植器官.
- 接受肺移植的人可能会因为副作用和缺乏直接的肺益处而出现更高的中止率.
- 与ETI和免疫抑制剂的药物相互作用是可以管理的,观察到塔克罗利斯水平的轻度至中度增加.
结论:
- 有限的数据需要进一步研究ETI在固体器官移植受体中的使用.
- 建议对肺移植接受者进行个别评估,特别是在出现非肺症状时.
- 对于非肺固体器官移植的接受者来说,对于囊性纤维化而言,ETI的好处可能超过了风险.
相关概念视频
Cystic Fibrosis: Management
151
Cystic fibrosis (CF) is an autosomal recessive disorder that predominantly affects individuals of Northern European descent, occurring at a rate of 1 in 3500. It is caused by a genetic mutation in a gene on chromosome 7, most commonly the ΔF508 mutation, that codes for the cystic fibrosis transmembrane conductance regulator (CFTR) protein. This results in thicker mucus secretions and obstruction pathologies in multiple organs, including the lungs and sinuses.
Sinus disease and chronic...
Sinus disease and chronic...
151
Drugs for Treatment of Ulcerative Colitis in IBD
133
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
133
Tissue Transplantation
352
Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
352
Treatment Resistant Cancers
3.3K
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
3.3K
Dosage Regimen: Fixed Dose
1.9K
Fixed-dose regimens are a common approach to administer drugs to achieve and maintain desired levels of the drug in the body. In this dosing strategy, a specific amount of medication is given at regular intervals, often multiple times a day, to ensure a consistent drug concentration in the bloodstream.
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
1.9K
Drugs for Peptic Ulcer Disease: Sucralfate as Mucosal Protective Agents
426
In the intricate landscape of the gastric lumen, excessive acid secretion disrupts the natural defense mechanisms, weakening the mucus-bicarbonate barrier. This vulnerability allows pepsin to infiltrate epithelial cells, digesting mucosal proteins and triggering erosion, leading to ulcer formation.
In this scenario, mucosal protective agents like sucralfate play an essential role. Sucralfate, a complex of sulfated sucrose and aluminum hydroxide, demonstrates its usefulness in acidic conditions,...
In this scenario, mucosal protective agents like sucralfate play an essential role. Sucralfate, a complex of sulfated sucrose and aluminum hydroxide, demonstrates its usefulness in acidic conditions,...
426


