与vigabatrin相关的症状性MRI毒性与患有婴儿的患者同时接受激素治疗有关
Rujuta Sathe1,2, Gyaneshwar Shrestha1,2, Aria Terango1,2
1Division of Pediatric Neurology, University of California, Los Angeles, California, USA.
Epilepsia open
|November 21, 2024
概括
治疗婴儿的儿童在MRI (VABAM) 上的维加巴特林相关的大脑异常与激素治疗有关. 这种组合疗法可能会增加症状性VABAM的风险,需要仔细的临床考虑.
科学领域:
- 儿科神经学 儿科神经学
- 神经成像是一种神经成像.
- 药物监督 药物监督 药物监督
背景情况:
- 维加巴特林是婴儿发作综合征 (IESS) 的关键治疗方法.
- 在MRI (VABAM) 上,与维加巴特林相关的大脑异常发生在约20%的治疗儿童中.
- VABAM可以无症状或有症状,有症状的病例可能与同时使用的疗法有关.
研究的目的:
- 调查接受维加巴的儿童中VABAM的危险因素.
- 评估激素治疗和症状性VABAM之间的关联.
主要方法:
- 108名儿童的回顾性队列研究,详细的维加巴暴露数据.
- 对候选风险因素的分析,包括维加巴林的峰值剂量和荷尔蒙疗法 (皮质类固醇或ACTH) 的同时使用.
主要成果:
- 在17名儿童 (11名有症状) 中发现了VABAM.
- 症状性VABAM显示与同时进行激素治疗有很强的关联 (p=0.001).
- 既没有症状也没有无症状的VABAM与峰值维加巴林剂量相关.
结论:
- 同时使用维加巴林和激素治疗与症状VABAM的风险增加有关.
- 没有确立因果关系;需要进一步研究.
- 临床医生应该平衡组合治疗的益处与症状VABAM的潜在风险.
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