结合性组织疾病相关的和非结合性组织疾病相关的间歇性肺部疾病之间的抗纤维素剂耐受性的差异
Tomoaki Nakamura1, Torahiko Jinta1, Atsushi Kitamura1
1Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, JPN.
Cureus
|March 12, 2025
概括
抗纤维素药物 (AFA) 在有或没有结缔组织疾病 (CTD-ILD) 的间歇性肺病患者中表现出类似的断药率. 然而,由于CTD-ILD患者的不良事件,特别是患有全身性硬化症患者的不良事件,Nintedanib的治疗较早停止.
科学领域:
- 肺部病理学 肺部病理学
- 类风湿病学 类风湿病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 抗纤维素药物 (AFA) 对于治疗与结合组织疾病 (CTD-ILD) 相关的间歇性肺病至关重要,尽管有潜在的副作用.
- 关于CTD-ILD中AFA耐受性的数据有限,特别是在结合组织疾病 (CTD) 引起的器官损伤方面.
- 这项研究调查了在CTD-ILD患者中由于CTD相关器官损伤,AFA是否耐受不良或过早中止.
研究的目的:
- 为了比较CTD-ILD和非CTD-ILD患者之间AFA的耐受性和停止率.
- 确定特定的AE导致这些群体中断.
- 探索AFA治疗持续时间的潜在差异,直到因不良事件而停止治疗.
主要方法:
- 对用宁泰达尼布或皮尔芬尼治疗的ILD患者的医疗记录的回顾性审查 (2008年12月 - 2022年11月).
- 对CTD-ILD组 (n=42) 与非CTD-ILD组 (n=129) 的比较.
- 收集的数据包括患者背景,由于不良事件 (AE) 的累积中止率,AFA使用的持续时间,导致中止的AE和死亡率.
主要成果:
- 在CTD-ILD和非CTD-ILD组之间,由于AEs导致的累积断药率没有显著差异,对于整体,宁泰达尼布或皮尔芬尼队列.
- 由于AE导致的停药,AFA使用的中位持续时间与皮尔费尼总体和皮尔费尼相似,但与非CTD-ILD组 (218天) 相比,CTD-ILD组的宁泰达尼布时间 (23天) 显著缩短.
- 胃肠道症状是停止治疗的最常见原因. 六名患有全身性硬化症 (SSc) 的女性CTD-ILD患者因AEs而停止使用tacrolimus因AEs而停止使用nintedanib.
结论:
- 在CTD-ILD和非CTD-ILD患者之间,由于AE导致的AFA终止率总体上没有显著差异.
- 在CTD-ILD患者中,因AEs而中止的宁达尼布发生的时间显著更快.
- 谨慎的AE预防策略对于接受宁泰达尼布的CTD-ILD患者至关重要,特别是那些SSc和/或tacrolimus的患者.
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