心力衰竭患者中芬瑞的不良影响:系统性审查和元分析
Wanqian Yu1, Fan Luo2, Jingan Rao1
1Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Frontiers in cardiovascular medicine
|June 11, 2025
概括
费内伦增加了高血和低血压的风险,但在心力衰竭患者的整体不良事件中显示出与安慰剂相似的安全性. 在HFrEF中,它可能比螺旋乳提供更好的安全性.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 菲内伦可以改善心力衰竭 (HF) 的结果,通过喷射分数亚型 (HFrEF,HFmrEF,HFpEF) 来改善心力衰竭.
- 费内伦的临床使用与显著的不良影响有关.
- 这项研究评估了不同HF表型中finerenone的不良事件风险.
研究的目的:
- 评估与安慰剂和其他矿物质皮质类受体对抗剂相比,与芬瑞相关的不良事件的相对风险.
- 分析各种心力衰竭表型中的这些风险.
主要方法:
- 在PubMed,Embase和Web of Science的系统文献搜索.
- 包括六项随机对照试验,其中包括8527名高风患者.
- 分析的重点是高胆血症,低血压,治疗出现的不良事件 (TEAE),治疗出现的严重不良事件 (TESAE) 和停止治疗.
主要成果:
- 费内伦显著增加了高卡血症 (RR=2.07) 和低血压 (RR=1.49) 风险与安慰剂相比,无论HF表型如何.
- 在整体HF人群中,在finerenone和安慰剂之间没有观察到TEAE,TESAE或停止治疗的显著差异.
- 费内伦显示TEAE (RR=0.93) 和TESAE (RR=0.74) 与eplerenone相比较低,停药率相似. 在HFrEF中,比起螺旋,费内伦的TEAE,断药和高血症风险较低.
结论:
- 费内伦 (10-25毫克) 在TEAE,TESAE和停止治疗方面具有与安慰剂相似的安全性.
- 费内伦比eplerenone具有更有利的安全性,具有较少的TEAE和TESAE.
- 在HFrEF患者中,与spironolactone相比,finerenone可能具有较低的TEAE风险,停止治疗和高血症.
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