药物治疗肌的治疗方法
Jennifer Spillane1, Jeroen Trip2, Gea Drost3
1Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK.
The Cochrane database of systematic reviews
|April 8, 2025
概括
这次审查发现了中度确定性的证据,证明西和拉莫特里金可以改善非肌痛性肌痛症的症状. 然而,并非所有患者都对这些治疗有反应,这凸显了对替代疗法的进一步研究的需要.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 肌,以延迟骨肌肉放松为特征,导致肌性疾病的残疾,如肌性缩和非肌性肌.
- 这些疾病表现为硬,和疲劳,显著影响患者的发病率和日常功能.
- 目前的治疗方法包括管阻断剂,二类药物和其他药物,正在进行改善疗效的研究.
研究的目的:
- 系统地审查随机对照试验 (RCT),评估临床肌性疾病中药物治疗的有效性和耐受性.
- 提供针对肌的药理干预措施的更新,基于证据的摘要.
主要方法:
- 在多个数据库 (Cochrane,MEDLINE,Embase等) 进行了搜索. 相关RCT的临床试验和临床试验注册到2023年3月.
- 包括参与者报告的肌结论的RCT,不包括非RCT和肌不是主要特征的条件.
- 独立提取数据,评估偏差风险,并使用GRADE标准评估证据的确定性.
主要成果:
- 梅克西莱丁显示了中度确定性证据,可以减少肌性缩症的放松时间,并改善非肌性缩症的硬度和定量手握.
- 拉莫特里金证明了改善放松时间的低确定性证据和改善非肌痛性肌痛症患者的生活质量的中等确定性证据.
- 报道了mexiletine和lamotrigine的不良反应,主要是胃肠道问题,昏迷和头痛;其他药物显示不确定的或无效的结果.
结论:
- 经过良好进行的RCT为非肌痛性肌痛症的症状治疗提供了中度确定性证据,尽管患者的反应有所不同.
- 对非响应者进行进一步的研究是必要的,并探索新型药物,如乙胺和弗莱卡尼尼德.
- 罕见疾病试验招募的挑战需要为未来的研究创新的试验设计.
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