间歇性与每日治疗非腔性Mycobacterium avium复杂肺部疾病:一个开放式随机试验
Taku Nakagawa1, Kohei Fujita2, Mari Miki3
1NHO Higashinagoya National Hospital, Repiratory Medicine, Nagoya, Aichi, Japan; nkgwtk2011@gmail.com.
Annals of the American Thoracic Society
|March 28, 2025
概括
间歇性治疗非腔结节性支气管切除性Mycobacterium avium复杂性肺病 (MAC-PD) 的疗效与每日治疗相似. 然而,每日治疗导致肝酶水平更高,而间歇治疗导致更多的味觉障碍.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 临床试验 临床试验
背景情况:
- 非洞腔结节性支气管切除 (NB) Mycobacterium avium复杂性肺病 (MAC-PD) 通常用间歇性,每周三次的治疗方案来治疗.
- 没有随机对照试验直接比较间歇性与每日治疗这种情况.
研究的目的:
- 为了评估间歇性与每日治疗的耐受性,安全性和有效性,用于以前未经治疗的非腔性NB MAC-PD.
- 为了比较两种治疗方案之间的疗程修改率,培养转换率和不良事件.
主要方法:
- 一项开放性研究随机将138名未接受过治疗的患者分为间歇性 (克拉里胺,利芬素,乙胺醇每周三次) 或每日 (较低剂量) 治疗一年.
- 主要终点是需要修改治疗方案的患者比例.
主要成果:
- 间歇性治疗和每日治疗组之间,治疗方案修改率 (20.0%对比33.8%) 和培养转换率 (70.3%对比80.0%) 并没有显著差异.
- 每日治疗与较高的AST和ALT升高率有关,而间歇性治疗导致比利鲁宾升高和缺血症.
- 与间歇性治疗组相比,每日治疗组的身体生活质量得分下降得更大.
结论:
- 间歇性治疗没有显著地比每日治疗更好地容忍非腔性NB MAC-PD.
- 这两种疗法都显示出相似的疗效,但安全性概况不同.
- 需要进行更大规模的研究,以进一步阐明MAC-PD的最佳治疗策略.
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