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Xov xwm

Raws li kev sim nyob sab Europe randomized, niaj hnub siv cov tshuaj hloov pauv hauv cov hlab ntshav tau ua rau muaj qhov tshwm sim ntau dua ntawm hypophosphatemia hauv cov neeg mob ntshav qab zib uas cuam tshuam nrog inflammatory plob tsis so tswj kab mob (IBD), txawm tias muaj kev sib piv ntawm hemoglobin thiab cov khw muag khoom hlau.
Heinz Zoller, MD, tshaj tawm tias nyob rau hauv PHOSPHARE-IBD ​​kev tshawb fawb ntawm 97 IBD cov neeg mob uas muaj hlau deficiency anemia teem rau hlau carboxymaltose (FCM; Injectafer) piv rau hlau demethylmaltose (FDI; Monoferric).siab dua hauv cov neeg mob., Medical University of Innsbruck, Austria, thiab cov npoj yaig.
Los ntawm lub hauv paus mus rau hnub 35, 51% ntawm FCM cov neeg mob thiab 8.3% ntawm cov neeg mob FDI muaj hypophosphatemia txhua lub sijhawm, raws li cov pov thawj ntawm cov ntshav phosphate tsawg dua 2.0 mg / dL (kho qhov kev pheej hmoo sib txawv - 42.8, 95% CI -57.1 txog -24.6. )., P<0,0001), — nyob rau hauv lub plab. , P<0.0001), pawg neeg sau ntawv hauv Gut.
Cov kws tshawb fawb tau siv tib koob tshuaj raws li hemoglobin thiab lub cev hnyav rau ob qho tib si khoom los txiav txim qhov muaj feem cuam tshuam rau hauv kev sim yav dhau los. Qhov tshwm sim siab tshaj plaws ntawm hypophosphatemia tshwm sim hauv thawj 2 lub lis piam ntawm kev txhaj tshuaj, thiab tseem nce siab hauv pawg FCM ntawm 70 hnub (59.2% vs 12.5%, P<0.0001). Qhov tshwm sim siab tshaj plaws ntawm hypophosphatemia tshwm sim hauv thawj 2 lub lis piam ntawm kev txhaj tshuaj, thiab tseem nce siab hauv pawg FCM ntawm 70 hnub (59.2% vs 12.5%, P<0.0001). Самая высокая частота гипофосфатемии возникла в течение первых 2 недель инфузии и оставалась повышенной в группе FCM через 70 дней (59,2% против 12,5%, P<0,0001). Qhov tshwm sim ntau tshaj plaws ntawm hypophosphatemia tshwm sim thaum thawj 2 lub lis piam ntawm kev txhaj tshuaj thiab tseem nce siab hauv pawg FCM tom qab 70 hnub (59.2% vs 12.5%, P<0.0001).低磷血症的最高发生率发生在输注的前2 周内,并且在FCM组在70 天时仍然升高 (<59.5% vs 1.0)低磷血症的最高发生率发生在输注的前2 周内,并且在FCM 组在70 天时仍然升高(59.2% 0,02.5% vs 1. Самая высокая частота гипофосфатемии возникла в течение первых 2 недель инфузии и оставалась повышенной в течение 70 дней в группе FCM (59,2% против 12,5%, P<0,0001). Qhov tshwm sim ntau tshaj plaws ntawm hypophosphatemia tshwm sim thaum thawj 2 lub lis piam ntawm kev txhaj tshuaj thiab tseem nce siab rau 70 hnub hauv pawg FCM (59.2% vs 12.5%, P<0.0001).
"Txawm hais tias muaj txiaj ntsig zoo ib yam thiab tsis muaj qhov sib txawv ntawm kev ua xua, ob qhov kev npaj siv tshuaj tua kab mob niaj hnub no feem ntau siv hauv Tebchaws Europe muaj qhov tseeb kev nyab xeeb, vim desmethylmaltose hlau tuaj yeem suav tias yog kev npaj muaj kev nyab xeeb dua," Zoller hais rau MedPage Hnub no.
Hlau deficiency anemia yog ib qho teeb meem hauv plab hnyuv ntawm IBD uas tuaj yeem ua rau lub cev tsis muaj zog thiab kev txawj ntse thiab ua rau muaj kev pheej hmoo ntawm kev mus pw hauv tsev kho mob.Raws li tau hais ua ntej, FCM thiab FDI tau pom tias muaj txiaj ntsig zoo sib xws hauv kev kho cov hlau tsis muaj ntshav ntshav nrog yuav luag qhov nce ntawm hemoglobin tom qab 70 hnub (25.2 thiab 24.9 g / l, feem).
Qhov sib txawv ntawm qhov tshwm sim ntawm hypophosphatemia ntawm ob hom tshuaj hloov hlau tau pom yav dhau los yog ib feem piav qhia los ntawm qhov hnyav lossis etiology ntawm cov hlau tsis muaj peev xwm, lub hauv paus raum ua haujlwm ntawm cov neeg mob, thiab kev siv tshuaj sib txawv rau cov tshuaj txhaj..Ib qho kev sim ua ntej dhau los piv rau ob txoj kev hloov pauv hlau, US PHOSPHARE-IDA kev sim, kuj tau pom tias muaj kev pheej hmoo ntau dua ntawm hypophosphatemia hauv FCM, txawm hais tias ntau npaum li cas thiab kev siv tshuaj sib txawv raws li FDA pom zoo cov ntaub ntawv tshuaj.
"Kev tshawb fawb tam sim no kuj tau qhia tias, txawm tias rov qab los ntawm hypophosphatemia, cov chav kawm ntawm kev hloov pauv biochemical cuam tshuam nrog kev qhia siab ntawm FGF23 [fibroblast growth factor 23], hu ua "6H syndrome", yog ywj siab ntawm cov neeg mob tau txais FCM," Zoller.thiab cov npoj yaig sau.
"Tshwj xeeb, cov pob txha tshwj xeeb [alkaline phosphatase] tseem nce siab hauv pawg FCM piv rau pawg FDI thaum hnub 70, txhais tau tias FCM cuam tshuam cov pob txha hloov mus thoob plaws qhov kev sim thiab dhau mus," lawv hais ntxiv."Qhov kev tshawb pom no tuaj yeem txuas hypophosphatemia rau osteomalacia, qhov teeb meem loj zuj zus ntawm FCM uas nyuam qhuav tau teev tseg raws li kev ceeb toom tshwj xeeb hauv European cov ntaub ntawv rau cov neeg mob FCM."
Zoller hais rau MedPage Hnub no hais tias kev tshawb fawb ntxiv "yog tsom rau kev nkag siab vim li cas ob cov tshuaj sib txawv hauv lawv qhov induction ntawm FGF23, ib yam tshuaj uas ua rau cov lus teb nyuaj ua rau hypophosphatemia, kom tsis txhob muaj kev txhim kho tshuaj yav tom ntej."Txhawm rau muaj qhov tshwm sim no thiab nkag siab txog qhov tsis zoo no. "”
PHOSPHARE-IBD ​​​​yog ob qhov muag tsis pom kev, randomized sim ntawm 97 IBD cov neeg mob - 61% nrog ulcerative colitis (UC) thiab 39% nrog Crohn's disease (CD) - hauv 20 lub tsev kho mob European txij li xyoo 2018. 2020.
Cov neeg mob tsim nyog yuav tsum muaj cov ntshav ferritin qib ntawm 100 ng / mL lossis qis dua, qib hemoglobin tsawg dua 130 g / L, thiab yuav tsum tau noj cov hlau sai sai lossis muaj qhov ncauj tsis haum rau cov hlau tsis haum / tsis hnov ​​​​tsw, ntawm lwm cov qauv.
Cov neeg koom nrog tau randomized hauv 1: 1 piv kom tau txais tib koob tshuaj FDI lossis FCM raws li hemoglobin thiab lub cev hnyav ntawm qhov pib thiab 35 hnub tom qab.Rau cov neeg mob uas muaj hemoglobin qis dua 100 g / l, tag nrho cov koob tshuaj yog 1500 mg rau cov neeg mob hnyav dua 70 kg thiab 2000 mg rau cov neeg mob hnyav 70 kg lossis ntau dua.Cov neeg mob uas muaj qib hemoglobin ntawm 100 g / l thiab siab dua tau txais tag nrho cov koob tshuaj ntawm 1500 mg.
Zoller thiab cov npoj yaig tau sau tias: "Raws li kev tsim qauv ntawm kev tshawb fawb, nws tuaj yeem txiav txim siab tias qhov sib txawv ntawm qhov tshwm sim ntawm hypophosphatemia yog vim qhov sib txawv ntawm cov hlau npaj, thiab tsis yog rau tag nrho cov tshuaj hlau, kev siv tshuaj, qhov sib txawv ntawm CD. piv nrog UC.lossis lwm yam cuam tshuam rau tus neeg mob xws li lub raum ua haujlwm, qhov mob hnyav, qib ntawm cov hlau tsis txaus, lossis vitamin D tsis txaus. "
Qhov nruab nrab hnub nyoog ntawm cov neeg mob nyob rau hauv txoj kev tshawb no yog 42 xyoo, 53% yog cov poj niam, feem ntau yog dawb (86%), thiab lub cev qhov hnyav nruab nrab yog 27.6.Qhov nruab nrab hemoglobin theem hauv paus yog 105 g / l.
Feem ntau ntawm cov xwm txheej tsis zoo (AEs) thiab cov xwm txheej tsis zoo (AEs) zoo sib xws rau cov khoom sib txawv, tab sis feem ntau ntawm lawv yog me me (80-83%).Pawg FCM muaj ntau cov vitamin D tsis txaus (35% vs 23%) thiab ntau tus neeg mob nasopharyngitis (20% vs 17%) dua li pawg FDI.Hauv pawg FDI, mob taub hau (19% vs. 10%) yog ntau dua, xws li xeev siab (13% vs. 2%).Ntau tus neeg mob hauv pawg FDI tau txiav kev kho mob ntxiv vim AEs (6% vs 2%).
Txawm hais tias ob qho kev cuam tshuam tau ua rau muaj kev txhim kho hauv cov neeg mob cov qhab nia qaug zog, kev txhim kho loj dua thiab nrawm dua tau pom hauv pawg FDI, txawm hais tias qhov sib txawv no poob qhov tseem ceeb tom qab 70 hnub.
Cov kev txwv cov ntaub ntawv suav nrog lub sijhawm luv luv thiab tsis muaj peev xwm los ntsuas cov txiaj ntsig kev kho mob tag nrho.
Zaina Hamza yog MedPage Niaj hnub no tus kws sau ntawv cov neeg ua haujlwm rau kev noj qab haus huv thiab kab mob sib kis.Nws nyob hauv Chicago.
Zoller tshaj tawm nyiaj txiag los ntawm Abbvie, Bayer, Falk, Gilead, Merz, Medice, Pierre Fabre, Pharmacosmos, Sanofi thiab Vifor.Cov kws sau ntawv qhia txog kev sib raug zoo nrog ntau lub tuam txhab tshuaj thiab kev lag luam.Tus kws sau ntawv kuj tau tshaj tawm cov kws sau ntawv ntawm patents ntsig txog kev npaj parenteral hlau.
LINK TO SOURCE: Zoller H et al."Hypophosphatemia tom qab kev tswj hwm ntawm cov hlau desferiomaltose thiab hlau carboxymaltose hauv cov neeg mob uas tsis muaj hlau tsis muaj ntshav liab vim muaj kab mob plab hnyuv (Phosphare-IBD): kev sim tshuaj ntsuam xyuas randomized" Gut 2022;DOI: 10.1136/gutjnl-2022-327897.
Cov ntaub ntawv hauv lub vev xaib no yog siv rau cov ntaub ntawv xov xwm nkaus xwb thiab tsis yog hloov pauv rau cov lus qhia kho mob, kuaj mob, lossis kev kho mob los ntawm tus kws kho mob tsim nyog.© 2022 MedPage Today LLC.Txhua txoj cai.Medpage Hnub no yog ib qho ntawm tsoom fwv teb chaws cov cim lag luam ntawm MedPage Today, LLC thiab tej zaum yuav tsis raug siv los ntawm cov neeg thib peb yam tsis tau tso cai.


Post lub sij hawm: Sep-23-2022