尼尔马特雷尔维尔 - 里托纳维尔在患有晚期功能障碍和COVID-19的患者中的安全性和有效性
Marimar Contreras Nieves1, Shuchi Anand1, I-Chun Thomas2
1Nephrology, Department of Medicine, Stanford University, Stanford, California.
概括
在患有晚期功能障碍的患者中使用涅马特里尔维尔 - 里托纳维尔可以降低急性呼吸衰竭和肺炎的风险. 与没有治疗相比,这种抗病毒疗法没有增加心脏,肝脏或脏问题的风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
背景情况:
- 尼尔马特里尔维尔-里托纳维尔是COVID-19的关键抗病毒药物,但在晚期功能障碍中存在安全问题.
- 患有晚期病的患者面临严重COVID-19并发症的高风险.
- 在这个人群中非标签使用尼马特里尔维尔-里托纳维尔需要安全性和有效性评估.
研究的目的:
- 检查尼马特里尔维尔 - 里托纳维尔在高级功能障碍患者 (eGFR 15-30 mL/min/1.73m2) 的非标签性使用的安全性和有效性.
- 为了比较尼尔马特雷尔维尔 - 里托纳维尔与没有抗病毒治疗或莫尔努皮拉维尔的结果.
主要方法:
- 追溯匹配的队列研究包括4020名COVID-19患者和eGFR15-30毫升/分钟/1.73m2.2.
- 使用倾向匹配和条件后勤回归来比较结果.
- 结果包括心脏事件,中风,急性损伤,肝损伤,呼吸衰竭和肺炎.
主要成果:
- 与没有抗病毒治疗相比,涅玛特里尔维尔-里托纳维尔与急性呼吸衰竭 (RR 0.5) 和肺炎 (RR 0.6) 的风险较低有关.
- 与没有治疗相比,没有观察到心血管事件,肝损伤或急性损伤风险的可检测差异.
- 与molnupiravir相比,nirmatrelvir-ritonavir对心血管事件和呼吸系统问题具有类似的风险,但急性损伤的风险更高.
结论:
- 在高级功能障碍中使用非标签的尼马特里尔维尔-里托纳维尔与呼吸道并发症的减少有关.
- 关于心脏,肝脏和脏不良事件的安全概况与不接受治疗相当.
- 现实世界的证据支持在这个高风险患者群体中使用nirmatrelvir-ritonavir.
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