在非透析依赖的CKD相关性贫血中对低剂量Roxadustat的有效性和安全性的随机试验
Ping Li1, Xuefeng Sun1, Li Zhang1
1Department of Nephrology, First Medical Center of Chinese PLA General Hospital, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Medical Devices and Integrated Traditional Chinese and Western Drug Development for Severe Kidney Diseases, Beijing Key Laboratory of Digital Intelligent TCM for the Prevention and Treatment of Pan-vascular Diseases, Key Disciplines of National Administration of Traditional Chinese Medicine (zyyzdxk-2023310), Beijing, China.
较低的开始剂量roxadustat没有满足慢性病 (CKD) 贫血的非劣质性,但达到可比的血红蛋白目标. 由于血红蛋白波动较小,建议在3-4阶段的CKD中使用较低的剂量.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 药理学 药理学是指药理学的学科.
背景情况:
- 贫血是慢性病 (CKD) 的常见并发症.
- 罗沙杜沙特是治疗慢性病患者的贫血的药物,使用不同的初始剂量.
- 在非透析的CKD患者中,罗沙杜沙特的最佳起始剂量需要进行研究.
研究的目的:
- 为了比较基于体重的较低初始剂量与标准初始剂量的较低初始剂量.
- 评估roxadustat在治疗无血病的有效性和安全性,在没有透析的3到5期慢性病患者.
主要方法:
- 这是一项随机对照试验,涉及254名患有3-5期慢性瘤但没有透析的患者.
- 患者在16周内接受了标准剂量或以体重为基础的一级较低的roxadustat起始剂量.
- 主要终点:基线 (第12至16周) 的平均血红蛋白变化;次要终点:血红蛋白目标的实现,可变性和救援疗法.
主要成果:
- 没有达到非劣质性,平均血红蛋白增加21.57g/l (较低剂量) 和26.35g/l (标准剂量).
- 达到目标血红蛋白 (100-120 g/l) 的比较比例: 46.0% (较低) 与 47.2% (标准) 相比.
- 较低剂量在5期CKD中显示出较少的血红蛋白增加和较低的血红蛋白变化率,具有可比的不良事件率.
结论:
- 较低的罗沙杜沙特起始剂量实现了可比的血红蛋白目标率,但没有达到平均血红蛋白变化的非劣质性.
- 较低剂量导致较少的血红蛋白波动,建议用于患有3至4期慢性结核病的患者.
- 可能需要进一步的研究,以优化对晚期CKD阶段的roxadustat剂量.
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