走向未知:在SARS-CoV-2血清阳性广泛蔓延的时代,实践中限制Remdesivir
Alyssa Christensen1, Zachary Nelson1, Sally Gustafson2
1HealthPartners and Park Nicollet Health Services, Minneapolis, MN.
概括
在免疫能力较强的患者中限制雷梅西维尔并没有增加死亡率. 这种抗病毒药物出乎意料地与限制后更高的ICU入院和机械通风使用有关,可能是由于患者选择.
科学领域:
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
- 临界护理医学 临界护理医学
背景情况:
- 在当前高血清阳性SARS-CoV-2时代,关于雷梅西维尔疗效的数据有限.
- 广泛的疫苗接种和先前的感染影响抗病毒治疗的效用.
研究的目的:
- 评价限制成年免疫能力者使用雷梅西维尔药物的影响.
- 为了评估死亡率和重症监护结果的变化后的remdesivir限制.
主要方法:
- 一个近乎实验性的,在8家医院系统中进行前后设计.
- 限制前的12个月 (2022年6月至2023年5月) 与限制后的12个月 (2023年7月至2024年6月) 相比.
- 主要结局是14天全因死亡率;次要结局包括28天死亡率,再入院,ICU入院和机械通风.
主要成果:
- 在限制后,雷梅西维尔的使用量显著下降 (37.7%至4.1%).
- 两组之间14天或28天全因死亡率没有显著差异.
- 限制后,雷梅西维尔的使用与增加ICU入院和机械通风有关.
结论:
- 在免疫能力较强的患者中限制雷梅西维尔并没有增加死亡率.
- 限制后的ICU入院和机械通风风险增加可能是由于接受remdesivir的患者的风险概况较高.
- 需要进一步的前性研究来澄清雷梅西维尔在高度接种疫苗,免疫能力强的人群中的益处.
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