时间和时间安排对levothyroxine对甲状腺功能减退控制的效果的影响:随机临床试验的试验顺序分析与试验分析的元分析
Bruno Simas da Rocha1, Vitor Bock Silveira2, Dimitris Varvaki Rados2
1Clinical Pharmacy Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
Endocrine
|April 12, 2025
概括
对于甲状腺功能低下症的levothyroxine坚持是有效的,每天的时间和每周的管理. 根据患者偏好的个性化剂量可以使甲状腺刺激激素 (TSH) 水平保持在正常范围内.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 治疗慢性疾病如甲状腺功能低下症的坚持是一个重大的临床挑战.
- 利沃甲状腺素是一种常见的甲状腺功能低下症治疗方法,并且对控制甲状腺刺激激素 (TSH) 水平至关重要.
研究的目的:
- 系统地审查和评估不同调度和时间策略对低甲状腺症患者的左甲状腺素坚持的影响.
- 为了评估晚上和早上服用的效果以及每周服用莱沃西对TSH水平的有效性.
主要方法:
- 在多个数据库 (PubMed,EMBASE,SCOPUS,Web of Science,CINAHL) 中进行了全面的文献搜索.
- 两个独立的审查员进行了研究选择,评估和数据提取.
- 进行了TSH水平的元分析,并使用试验序列分析 (TSA) 来评估结果的可靠性.
主要成果:
- 十一项研究符合纳入标准,重点是晚上 (8项研究) 或每周 (3项研究) 服用莱沃西.
- 在晚上和早上给药之间没有观察到TSH水平的显著差异.
- 每周给药导致TSH水平更高,尽管仍在参考范围内,TSA证实了足够的数据用于调度干预.
结论:
- 每天的时间 (晚上和早上) 和每周的莱沃西剂都有效地维持TSH水平在正常参考范围内.
- 应该探索个性化的勒沃西剂量方案,考虑患者的方便和偏好.
相关概念视频
Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response
31
Circadian rhythms are cyclic changes that are crucial in plasma drug concentrations. Various standard circadian parameters, including core body temperature, heart rate, and other cardiovascular factors, directly impact disease states and the therapeutic response to drug therapy.
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
31
Synthesis and Regulation of Thyroid Hormones
4.0K
Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
4.0K
Drug Therapy
30
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
30
Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
50
The elimination half-life and drug clearance of drugs following nonlinear kinetics can vary with dosage. The Michaelis-Menten parameters and drug concentration influence these factors. As the dose increases, the elimination half-life tends to lengthen, resulting in a reduction in clearance and a disproportionately larger area under the curve. The total clearance can be derived from the Michaelis-Menten equation for drugs following a one-compartment model.
A study on guinea pigs examined the...
A study on guinea pigs examined the...
50
Drug Dosage Regimen: Overview
3.3K
A drug dosage regimen describes the specific instructions and schedule for administering a drug to a patient. It considers factors such as drug dosage, frequency, route of administration, and duration of treatment. Designing an appropriate dosage regimen for a patient aims to achieve a target drug concentration at the site of action.
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
3.3K
Chronopharmacokinetics: Time-Dependent Pharmacokinetics
69
Chronopharmacokinetics studies the temporal change in drug absorption and elimination. These changes can be cyclical or non-cyclical. Cyclical changes occur over a regular interval, while non-cyclical changes occur over a longer, irregular period.
Time-dependent pharmacokinetics refers to non-cyclical changes in drug rate processes over a period of time. It can lead to nonlinear pharmacokinetics, where the relationship between drug concentration and time is not proportional. Non-cyclical...
Time-dependent pharmacokinetics refers to non-cyclical changes in drug rate processes over a period of time. It can lead to nonlinear pharmacokinetics, where the relationship between drug concentration and time is not proportional. Non-cyclical...
69


