平衡行为:在免疫检查点抑制剂肝炎策略,结果和风险中缩小mycophenolate mofetil
Sahaj Mujumdar1, Sofia Shaikh1, Shu-Yen Chan2
1Department of Gastroenterology and Hepatology, University of Rochester Medical Center, Rochester, NY 14682, United States.
World journal of gastrointestinal pharmacology and therapeutics
|December 11, 2025
概括
针对免疫检查点抑制剂 (ICI) 肝炎的缩菌酸 (MMF) 缺乏标准化,造成复发风险并影响癌症治疗. 对最优的货币货币基金退出策略需要进一步的研究.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 肝病学 肝病学是一种肝病学.
背景情况:
- 免疫检查点抑制剂 (ICI) 已经改变了癌症治疗,但可以导致免疫相关的不良事件,如ICI肝炎.
- 菌酸莫菲提尔 (MMF) 是一种常见的二线治疗类固醇耐药ICI肝炎的治疗方法.
- 目前的货币货币基金逐渐减少协议没有标准化,这在管理复发风险和长期结果方面造成了不确定性.
研究的目的:
- 审查现有证据,关于货币市场基金在ICI肝炎中逐渐减少策略.
- 分析临床结果,复发风险,以及在货币市场基金退出后重新引入ICI的可行性.
主要方法:
- 在PubMed,EMBASE和临床试验注册表中进行了全面的文献搜索.
- 提取了有关患者特征,货币货币基金治疗方案,逐渐减少的持续时间,复发率和瘤结局的数据.
- 分析了复发和成功逐渐减少的风险因素.
主要成果:
- 货币货币基金的逐渐持续时间存在显著的异质性,从4周到6个月以上.
- 缩短时间表是根据肝损伤严重程度,治疗反应和复发风险因素进行个性化的.
- 总结了当前的方法,成功逐渐减少的预测因素和替代性免疫抑制策略.
结论:
- 货币货币基金对ICI肝炎有效,但逐渐减少带来了潜在的肝炎爆发和疾病进展风险的挑战.
- 标准化的逐渐缩减协议对于平衡免疫抑制和抗癌疗效至关重要.
- 未来的研究应该优先考虑基于生物标志物的策略和前性试验,以开发最佳实践.
相关概念视频
01:26Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
200
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
200
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
169
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
169
01:16Kidney Transplant III: Nursing Management
289
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
289
01:29Therapeutic Drug Monitoring: Affecting Factors
175
Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
175
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
459
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
459
01:08Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment
236
Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...
236