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处理延迟或错过的直接口服抗凝剂剂量:基于模型的个人补救剂量
Xiao-Qin Liu1, Zi-Ran Li2, Chen-Yu Wang1
1Department of Pharmacy, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Blood advances
|September 18, 2024
概括
直接口服抗凝剂 (DOAC) 的个性化剂量策略可以减轻错过或延迟剂量的风险. 这种使用药理动力学建模的方法提供了比当前指导方针更好的解决方案,用于管理不坚持抗凝治疗.
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
- 药学指标 (Pharmacometrics) 是一个指标.
背景情况:
- 不坚持直接口服抗凝剂 (DOAC) 的使用会增加血栓栓塞和出血的风险.
- 目前管理延迟或错过的DOAC剂量的指导方针缺乏个性化和证据.
- 延迟或错过剂量是最常见的不坚持的形式.
研究的目的:
- 为延迟或错过的DOAC剂量制定个性化的补救剂量策略.
- 创建一个工具,根据患者因素和延迟持续时间,推个性化剂量调整.
- 通过尽量减少治疗范围之外的时间来提高患者安全.
主要方法:
- 人口药理动力学-药理动力学 (PK-PD) 建模和仿真被用于开发剂量策略.
- 分析了关于DOACs (rivaroxaban,apixaban,edoxaban,dabigatran etexilate) 的已发表文献中的数据.
- 创建了一个基于Web的仪表板 (R-shiny),以提供实时的剂量建议.
主要成果:
- 补救剂量方案旨在快速恢复治疗药物度或生物标志物.
- 与当前推相比,开发的策略显示治疗范围之外的偏差时间较短.
- 患者特定的因素,如年龄,体重,功能和多药性对策略产生了轻微影响.
结论:
- 对DOACs的个性化补救剂量策略优于目前的指导方针.
- R-shiny仪表板为临床医生提供了一个实用的工具,可以有效地管理错过或延迟的DOAC剂量.
- 个性化策略有助于减轻与DOAC不坚持相关的出血和血栓形成风险.
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