影响塔克罗利斯患者内变异性的因素和干预措施:系统性审查和元分析
Hongsheng Chen1, Shuang Liu2, Lingling Yu1
1Department of Pharmacy, Peking University Third Hospital, Beijing, China; Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China.
Transplantation reviews (Orlando, Fla.)
|September 11, 2024
概括
塔克罗利莫斯水平的内科变异性 (IPV) 受遗传学,坚持和种族的影响,但在延长释放配方中较低. 药剂师参与改善了IPV,突出了针对性的干预措施,以获得更好的结果.
科学领域:
- 药理学 药理学是指药理学的学科.
- 免疫抑制是一种免疫抑制.
- 临床药房 临床药房
背景情况:
- 塔克罗利莫斯对移植后免疫抑制至关重要,但低谷水平在反映药物波动方面存在限制.
- 患者内可变性 (IPV) 是预测临床结果的新标志物,但影响它的因素和干预措施尚不清楚.
研究的目的:
- 系统地审查影响塔克罗利斯IPV的因素.
- 评估干预措施对降低塔克罗利斯IPV的影响,以改善临床管理.
主要方法:
- 全面的电子数据库搜索 (PubMed,Embase,Cochrane) 截至2023年10月.
- 包括15个RCT,34个队列研究和20个自我控制研究.
- 使用RevMan 5.4.1软件进行的元分析.
主要成果:
- 在CYP3A5表达者,非附着患者,PPI/他类药物患者和黑人接受者中观察到更高的IPV.
- 在使用延长释放塔克罗利斯配方的患者中观察到较低的IPV.
- 药剂师参与表明对减少IPV产生积极影响.
结论:
- 影响塔克罗利斯IPV的关键因素包括基因型,配方,坚持,药物相互作用和种族.
- 识别这些因素对于制定有针对性的干预措施至关重要.
- 药剂师的参与有希望;需要进一步研究移动技术,教育和个性化剂量.
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