与mycophenolate相比,在接受阿扎西奥普林的肺移植患者中的结果
David M Sanborn1, Joelle N Friesen2, Hemang Yadav1
1Division of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First St. SW Rochester, MN, 55905, USA.
Respiratory medicine
|February 12, 2025
概括
与阿扎西奥普林 (AZA) 相比,mycophenolate (MMF) 减少了肺移植后的急性细胞排斥和药物中断. 这两种免疫抑制剂的移植损失,慢性肺异位移植功能障碍和感染率相似.
科学领域:
- 免疫学 免疫学 免疫学
- 移植医学 移植医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 肺移植需要免疫抑制以防止移植损失.
- 维护性免疫抑制疗法,特别是mycophenolate (MMF) 与azathioprine (AZA),缺乏肺移植接受者的直接比较数据.
研究的目的:
- 为了比较维护免疫抑制与MMF与AZA在肺移植接受者的疗效和安全性.
- 评估MMF和AZA对急性细胞排斥,移植损失,药物中断,慢性肺异位移植功能障碍 (CLAD) 和感染的影响.
主要方法:
- 在梅奥诊所 (2009-2022) 成年肺移植接受者的回顾性队列研究.
- 接受AZA和MMF维持免疫抑制的患者之间的结局的比较.
- 多变量Cox回归分析调整移植时代和诱导免疫抑制.
主要成果:
- 该研究包括224名肺移植接受者 (88名AZA,136名MMF).
- 与MMF相比,接受AZA的患者患有临床显著的急性细胞排斥 (HR,1.76;P=0.02) 和药物中断 (HR,1.47;P=0.026) 的风险明显更高.
- 在AZA和MMF组之间,CLAD,移植损失和感染率是可比的.
结论:
- 与阿扎西奥普林 (AZA) 相比,mycophenolate (MMF) 与肺移植接受者的急性细胞排斥和药物中断风险较低.
- 无论是MMF还是AZA,都表现出类似的慢性肺异位移植功能障碍,移植损失和感染率.
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