LANCET:Polypills在心血管疾病中的使用现状!

2017-03-18 MedSci MedSci原创

Polypills已经在超过30个国家获得批准,但是与其他疾病如HIV,结核病和疟疾的固定剂量组合不同,世界范围内Polypills的经验和可用性仍然有限。近期,一篇发表在权威杂志LANCET上的评价旨在提出一个指南,用于在未来的研究和临床活动中使用Polypills,以及合成当代现有的证据来支持使用Polypills预防动脉粥样硬化。Polypill的用途可以按照人口和指标分类,这两者都会影响益

Polypills已经在超过30个国家获得批准,但是与其他疾病如HIV,结核病和疟疾的固定剂量组合不同,世界范围内Polypills的经验和可用性仍然有限。


近期,一篇发表在权威杂志LANCET上的评价旨在提出一个指南,用于在未来的研究和临床活动中使用Polypills,以及合成当代现有的证据来支持使用Polypills预防动脉粥样硬化。

Polypill的用途可以按照人口和指标分类,这两者都会影响益处和风险之间的平衡。人群包括二级预防,基于正式风险评估的高风险一级预防以及基于单一风险因素测量的一级预防,如年龄,也称为大规模治疗。

对于每个群体,潜在的适应症是当前药物治疗的起始、升级和单个药物组分的直接替代。

此篇文章共总结了32个国家完成的13个Polypills试验(9059名参与者)的疗效和安全性结果。

结果显示:虽然异质性限制了对危险因素影响的确定性,但是,Polypill可以提高依从性,良好的耐受性,并降低危险因素的水平。

迄今为止发表的相关数据并未设计用于检测临床结果的差异,因此已报道的Polypills组和比较组之间没有显着差异。

Polypill的治疗方法可能是一个可以扩展的战略,通过改善药物依从性和可获得性,到2025年可以减少动脉粥样硬化过早死亡风险的25%,但更进一步的试验数据和临床经验将有助于确定如何最佳地实施Polypills这一目标。

原始出处:
Huffman MD, Xavier D, Perel P. Uses of polypills for cardiovascular disease and evidence to date. Lancet. 2017 Mar 11;389(10073):1055-1065. doi: 10.1016/S0140-6736(17)30553-6.

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    2018-01-20 howi
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    2017-03-20 yxch42
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    2017-03-18 1e10c84am36(暂无匿称)

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LANCET:Polypills面临的挑战

超过30个国家的心血管多效药丸(polypills)监管批准正在快速增长。现有证据清楚地显示多效药丸可以改善具有使用药物组分(即具有确定的心血管疾病或高风险的患者)适应症患者的依从性和心血管疾病危险因素。然而,将多效药丸应用到临床实践中具有许多挑战。临床试验文献提供了对于多效药丸策略的临床影响的洞察,包括成本效益、使用安全性、依从性的实质性改善以及比常规护理更好的风险因子控制。尽管,目前需要这样的