在接受维持透析的患者中,螺旋和安慰剂 (ACHIEVE):国际,并行组,随机对照试验
Michael Walsh1, David Collister2, Martin Gallagher3
1Population Health Research Institute, Hamilton Health Sciences/McMaster University, Hamilton, ON, Canada; Department of Medicine and Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Lancet (London, England)
|August 16, 2025
概括
在维持透析的患者中,螺旋没有减少心血管死亡或心力衰竭住院. 这项研究发现,在这种高风险人群中,开始服用螺旋没有任何益处.
科学领域:
- 肝脏病学
- 心脏病学
- 临床试验
背景情况:
- 接受维持透析的患者面临显著的心血管风险.
- 矿物质皮质激素受体抗剂,如螺旋,是潜在的治疗方法.
研究的目的:
- 确定螺旋是否降低了透析患者的心血管死亡率和心力衰竭住院.
主要方法:
- ACHIEVE试验是一项随机对照试验,涉及143个透析项目中的2538名患者.
- 参与者每天接受25毫克的螺旋或安慰剂.
- 主要结局是心血管死亡或心力衰竭住院.
主要成果:
- 在进行中期分析后,
- 与安慰剂相比,螺旋没有显著降低组合初级结果 (HR 0. 92; p=0. 35).
- 两组之间没有观察到任何原因的死亡率或住院病例的显著差异.
结论:
- 在接受维持透析的患者中,每天口服的螺旋 (25 mg) 并没有改善心血管结果.
- 在这一群体中开始使用螺旋没有明显的益处.
- 未来的研究应探索减轻透析患者心血管风险的替代策略.
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