用普雷尼松或甲基酸治疗肺部沙丘病的第一线治疗方法
Vivienne Kahlmann1, Montse Janssen Bonás2, Catharina C Moor1
1Center of Excellence for Interstitial Lung Diseases and Sarcoidosis (member of the European Reference Network on Rare Respiratory Diseases), Department of Respiratory Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands.
甲托雷克萨特与普得尼松一样有效,用于初始的肺性沙尔科毒症治疗. 两种药物都显示出类似的疗效,但甲状腺素可能为患者-提供者决策提供不同的副作用配置文件.
科学领域:
- 肺部医学 肺部医学
- 临床药理学 临床药理学
背景情况:
- 肺部型硬化症治疗指南建议使用普得尼松作为一线治疗.
- 普雷尼松与显著的副作用有关,促使研究替代品.
- 第二线药物甲托雷克萨特的开始较慢,但潜在的副作用较少.
研究的目的:
- 为了比较甲索特雷克萨特和普得尼松作为肺癌沙丘病的第一线治疗方法的疗效和副作用概况.
- 为了确定甲状腺素是否在改善肺功能方面与普得尼松无差.
主要方法:
- 一个多中心的,开放的,非劣势性试验随机分配了138名肺癌沙尔科毒的未经治疗的患者.
- 患者接受了普得尼松或甲状腺素 (1:1比率).
- 主要终点是从基线到第24周预测强迫生命能力 (FVC) 的百分比平均变化.
主要成果:
- 甲托雷克萨特与普得尼松无差,在24周内预测的FVC百分比的平均变化类似.
- 甲铁和普得尼松之间FVC变化的调整后差异为-1.17个百分点 (95% CI, -4.27至1.93).
- 在相似比例的患者中报告了不良事件;两组之间常见的副作用有所不同.
结论:
- 在FVC改善方面,初始用甲状腺素治疗对于肺性沙丘病的普得尼松没有劣势.
- 甲索特和普得尼松之间的副作用概况的差异可以指导治疗选择的共享决策.
- 进一步的研究可能会根据个体患者的个人资料澄清最佳治疗策略.
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