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循环利尿剂对骨质疏松症中代诺苏马布诱导的低血症的影响:一个回顾性观察分析
Toshinori Hirai1,2, Yukari Mori1, Toru Ogura3
1Department of Pharmacy, Faculty of Medicine, Mie University Hospital, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Journal of pharmaceutical health care and sciences
|September 28, 2024
概括
循环利尿剂可能会增加骨质疏松症患者的德诺苏马布诱导的低血症的风险. 这种风险与尿路分泌量增加有关,但可以通过补充和维生素D来减轻.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 骨质疏松症的治疗通常涉及骨质再吸收抑制剂denosumab.
- 已知循环利尿剂会增加尿路分泌.
- 关于水平的德诺苏马布和循环利尿剂之间的潜在相互作用尚未完全理解.
研究的目的:
- 调查骨质疏松症患者中登苏马布和低血症之间的关联,特别是与循环利尿剂同时使用时.
- 为了确定denosumab诱导的低血症的预测因素.
主要方法:
- 对日本自发不良药事件报告的分析,以检测用循环利尿剂检测德诺苏马布诱导的低血症的信号.
- 使用多变量逻辑回归,对骨质疏松症患者进行回顾性研究,以确定缺血症预测因子 (校正<8.5 mg/dL).
- 在接受单独denosumab和接受denosumab加循环利尿剂的患者之间,纠正的水平 (ΔCa) 变化的比较.
主要成果:
- 检测到denosumab诱导的低血症的一个显著信号 (报告OR = 865.8,p < 0.0001).
- 在164名患者中,12%的循环利尿剂与低血症 (OR = 6.410,p = 0.0494) 有意义地相关.
- 较高的基线校正水平和/维生素D补充剂与较低的低血症风险相关 (分别为OR=0.032和0.285).
- 在非低血症患者中,与单独使用denosumab相比,使用denosumab加循环利尿剂的 ΔCa 降低更为显著.
- 然而,在低血症患者中,不管循环利尿剂是否同时服用,ΔCa仍然可比.
结论:
- 循环利尿剂可能会使患者易于发展denosumab诱导的低血症.
- 补充和维生素D可能会起到保护性作用,防止denosumab诱导的低血症.
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