治疗性埃诺沙巴林在肥胖症中的剂量
Marcelle Appay1,2, Shreyas Kharadi1, Sajani Nanayakkara1
1School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
The Annals of pharmacotherapy
|August 7, 2024
概括
这次审查发现,对于肥胖患者的最佳埃诺沙巴林剂量没有足够的证据. 抗因子Xa (AFXa) 监测可以指导治疗,但需要进一步研究才能确定确定的剂量方案.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
- 肥胖医学 肥胖医学
背景情况:
- 埃诺沙巴林是一种广泛使用的抗凝剂.
- 肥胖症在药物治疗中存在独特的挑战,因为药物分布和新陈代谢发生了变化.
- 肥胖患者的最佳治疗性埃诺沙巴林剂量尚不清楚.
研究的目的:
- 系统地审查有关治疗性埃诺沙巴林在肥胖患者中的疗效和安全性的现有数据.
- 为了确定关于肥胖症的埃诺沙巴林剂量策略的研究缺口.
主要方法:
- 在Medline和Embase数据库进行系统的文献搜索,截至2023年12月20日.
- 包括报告治疗性埃诺沙巴林剂量,出血,血栓结局或肥胖成年人抗Xa (AFXa) 监测的研究.
- 数据提取和研究选择使用Covidence进行管理,并对额外研究进行参考清单选.
主要成果:
- 包括16项研究,在剂量,指示和设计方面表现出显著的异质性.
- 血栓事件发生的患者中位数为1.3%,而出血事件发生的患者中位数为5.7%.
- 关于身体质量指数 (BMI) 和基于体重的剂量对AFXa水平的影响,观察到相互矛盾的结果,一项研究表明实际体重剂量预测了超治疗水平.
结论:
- 研究中的异质性使得无法为肥胖患者制定最佳的埃诺沙巴林剂量策略.
- 抗因子Xa (AFXa) 监测可能是指导这个人群中埃诺沙巴林剂量的宝贵工具.
- 进一步的研究是必要的,以确定适合和有效的素对肥胖个体的剂量方案.
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