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使用不同的功能估计方程对万科米辛剂量的影响
Laura Gratacós1, Dolors Soy-Muner2
1Pharmacy, Hospital Universitario de Girona Doctor Josep Trueta, Girona, Spain lgratacos.girona.ics@gencat.cat.
考克克罗夫特-高尔特 (CG) 公式最好地预测了万科米辛的最低度 (Cmin). 功能估计方程在优化万科米辛剂量方面是不可互换的.
科学领域:
- 药理动力学和药理动力学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
背景情况:
- 精确估计功能对于优化万科米辛剂量至关重要.
- 为了估计功能,存在多种公式,包括Cockcroft-Gault (CG),CKD-EPI和MDRD.
- 这些配方的可互换性,用于范胺剂量调整,需要进一步研究.
研究的目的:
- 为了比较CG,CKD-EPI和MDRD公式在预测万科米辛最小度 (Cmin) 中的准确性.
- 为了确定这些配方是否可以互换地用于万科米辛剂量优化.
主要方法:
- 对接受静脉注射万科米辛的住院成年患者进行了观察性回顾性研究.
- 排除标准包括严重的功能障碍,高的BMI,体外清除和不稳定的功能.
- 贝叶斯分析被用来获得个别的药理学参数,包括通过CG,CKD-EPI和MDRD公式估计的米素清除率 (CLvan).
- 估计的Cmin (eCmin) 与观察到的Cmin使用课内相关系数 (ICC) 和卡帕系数对曲线下面面积 (AUC) 的一致性进行比较.
主要成果:
- 在大多数子组中,CG公式显示了与观察到的Cmin (ICC>0.7) 的统计学上显著更好的一致性.
- 只有在血清肌素 (Scr) >1.1 mg/dL的患者中,MDRD和CKD-EPI与CG显示出足够的一致性.
- 在各个子组之间达成的协议有所不同,CG在低体重和老年患者中显示出优异的Cmin预测.
结论:
- 考克克罗夫特-高尔特 (CG) 公式是最准确的预测万科米辛Cmin.
- 在特定的亚组中,MDRD公式显示出良好的预测能力 (eGFR <60 mL/min,年龄46-75岁).
- 功能估计公式在优化万科米辛剂量方面是不可互换的,这凸显了根据患者特征选择合适配方的重要性.
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