盘点:7月18日Lancet子刊研究一览

2017-07-18 zhangfan MedSci原创

7月18日Lancet子刊研究一览

【1】Lancet Oncol:Tremelimumab晚期恶性间皮瘤II期临床失败

近日研究人员评估了CTLA-4单抗tremelimumab用于晚期恶性间皮瘤的疗效。

名为DETERMINE的研究是一项IIb临床研究,参与者为不可切除的胸膜或腹膜恶性间皮瘤,患者经一到两次全身治疗后进展为晚期疾病。患者随机静脉注射tremelimumab (10 mg/kg)或安慰剂,每12周中的4周接受7剂量药物直至治疗终止。主要终点是总生存期。

研究招募571人,tremelimumab组382人,安慰剂组189人。截至2016年1月24日,80%的治疗组以及81%的对照组患者死亡,中位生存期差异不显著(7.7 vs 7.3个月)。65%的治疗组以及48%的安慰剂组患者发生3级以上不良事件,包括呼吸困难、腹泻以及肠炎。9%的治疗组以及6%的对照组患者死于治疗导致的突发事件包括间皮瘤、呼吸困难、呼吸衰竭、心肌梗塞、肺炎、心衰以及肠炎。

研究认为Tremelimumab不能提高晚期恶性间皮瘤患者生存期(文章详见—— Lancet Oncolo:Tremelimumab晚期恶性间皮瘤II期临床失败)

【2】Lancet Infect Dis:灭活全菌口服霍乱疫苗效果研究

灭活全菌口服霍乱疫苗是(kOCVs)是霍乱防治的新标准。近日研究人员对kocv疗效和效益评估进行系统综述和荟萃分析。

研究对截至2016年7月的相关研究文献进行检索总结,从已发表的研究中提取研究的主要有效性和有效性估计并根据疫苗剂量、持续时间和年龄组进行分析。本研究的目的是考察 kOCV的平均效果以及2剂量疫苗的直接效果,效果研究使用随机效应模型。

研究包含了7个临床研究以及6个观察研究,总计912人。2剂量疫苗对的平均效益为58-76%。5岁以下儿童的效益为30%,低于5岁以上儿童的64%。kOCV接种前2年的效果差异不显著,第1年为56%,第2年为59%,但第3和4年的效果下降至39%和26%。

研究表明2剂量的灭活全菌口服霍乱疫苗可提供3年的有效预防,有规律的预防接种是预防效果最大化的有效途径。(文章详见——Lancet Infect Dis:灭活全菌口服霍乱疫苗效果研究)

【3】Lancet HIV:dolutegravir用于HIV-1女性感染者的治疗

Dolutegravir由于良好的药代动力学特征,可每日一次用于治疗HIV-1感染。近日研究人员考察了dolutegravir治疗HIV-1女性感染者的疗效以及安全性。

名为ARIA的IIIb临床研究在12个国家的86所医院开展,成年的,病毒RNA拷贝数大于500/mL的,HLA-B*5701等位基因阴性的女性患者参与。患者接受标准的dolutegravir治疗(治疗组)或阿扎那韦+泰诺福韦酯+恩曲他滨的联合治疗(对照组)。主要终点是治疗48周后病毒拷贝低于50的患者比例。

研究招募患者499人,其中治疗组250人,对照组249人。48周时,治疗组达到主要终点患者比例为82%,对照组为71%(平均差异10.5%, 95% CI 3.1-17.8, p=0.005)。对照组1人因核苷类逆转录酶抑制剂相关耐药导致恩曲他滨敏感性降低。组间不良事件相近,最常见的不良事件包括恶心和头痛。治疗组的不良事件率(33%vs49%),停药率(4%vs7%)低于对照组。

研究发现,dolutegravir具有较好的疗效和安全性,可用于之前未接受过治疗的HIV-1型女性感染者。(文章详见——Lancet HIV:dolutegravir用于HIV-1女性感染者的治疗)

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    2017-10-20 howi
  2. [GetPortalCommentsPageByObjectIdResponse(id=1829088, encodeId=d3b2182908887, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Fri Oct 20 05:38:00 CST 2017, time=2017-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=224529, encodeId=36fa22452986, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Fri Jul 21 07:39:08 CST 2017, time=2017-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=223955, encodeId=eab6223955ed, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Wed Jul 19 18:32:56 CST 2017, time=2017-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=223516, encodeId=ce1a2235166a, content=灭活全菌口服霍乱疫苗是(kOCVs)是霍乱防治的新标准, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuF63NQckT5BOaic1el7cRelbpr859YXtZQHQSaWnqZCRPOZzDBcjsBNx7AFefLHh1UvMPS4kPP0BG/0, createdBy=47831990981, createdName=1e1a50a1m36(暂无匿称), createdTime=Tue Jul 18 11:43:26 CST 2017, time=2017-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=223512, encodeId=c3732235129e, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Tue Jul 18 11:14:01 CST 2017, time=2017-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=223511, encodeId=5be622351107, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2emBzjO0FtqTJ05AqrEEdRmp6tmlsLXqpzfxWdtgbbgPGWRHagoK9fLTd3IayRPgkJVIVBWtdlmnkBhOIR4cFM/0, createdBy=e8d51649330, createdName=飘飘爱, createdTime=Tue Jul 18 10:59:53 CST 2017, time=2017-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=223510, encodeId=b0e4223510ac, content=谢谢分享受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=12, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM5vZbLiaw0G6FFQ3J4obXJNXbFJZBOJIsBiasEmSFCxzhibZ2TT0xftAW5kV1SLyo6jg0hOMaJg1Alm15kbuoDUFIsUM4JP7bdvcA/0, createdBy=10082062447, createdName=医无止境。, createdTime=Tue Jul 18 10:58:08 CST 2017, time=2017-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=223509, encodeId=f34e223509de, content=谢谢分享受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=14, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ae02063908, createdName=152****8376, createdTime=Tue Jul 18 10:55:18 CST 2017, time=2017-07-18, status=1, ipAttribution=)]
    2017-07-21 李东泽

    很好,不错,以后会多学习

    0

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    2017-07-19 往日如昨

    学习了谢谢分享

    0

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    2017-07-18 1e1a50a1m36(暂无匿称)

    灭活全菌口服霍乱疫苗是(kOCVs)是霍乱防治的新标准

    0

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    2017-07-18 1e0f8808m18(暂无匿称)

    学习了,谢谢分享。

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1829088, encodeId=d3b2182908887, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Fri Oct 20 05:38:00 CST 2017, time=2017-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=224529, encodeId=36fa22452986, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Fri Jul 21 07:39:08 CST 2017, time=2017-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=223955, encodeId=eab6223955ed, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Wed Jul 19 18:32:56 CST 2017, time=2017-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=223516, encodeId=ce1a2235166a, content=灭活全菌口服霍乱疫苗是(kOCVs)是霍乱防治的新标准, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuF63NQckT5BOaic1el7cRelbpr859YXtZQHQSaWnqZCRPOZzDBcjsBNx7AFefLHh1UvMPS4kPP0BG/0, createdBy=47831990981, createdName=1e1a50a1m36(暂无匿称), createdTime=Tue Jul 18 11:43:26 CST 2017, time=2017-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=223512, encodeId=c3732235129e, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Tue Jul 18 11:14:01 CST 2017, time=2017-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=223511, encodeId=5be622351107, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2emBzjO0FtqTJ05AqrEEdRmp6tmlsLXqpzfxWdtgbbgPGWRHagoK9fLTd3IayRPgkJVIVBWtdlmnkBhOIR4cFM/0, createdBy=e8d51649330, createdName=飘飘爱, createdTime=Tue Jul 18 10:59:53 CST 2017, time=2017-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=223510, encodeId=b0e4223510ac, content=谢谢分享受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=12, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM5vZbLiaw0G6FFQ3J4obXJNXbFJZBOJIsBiasEmSFCxzhibZ2TT0xftAW5kV1SLyo6jg0hOMaJg1Alm15kbuoDUFIsUM4JP7bdvcA/0, createdBy=10082062447, createdName=医无止境。, createdTime=Tue Jul 18 10:58:08 CST 2017, time=2017-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=223509, encodeId=f34e223509de, content=谢谢分享受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=14, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ae02063908, createdName=152****8376, createdTime=Tue Jul 18 10:55:18 CST 2017, time=2017-07-18, status=1, ipAttribution=)]
    2017-07-18 飘飘爱

    很好

    0

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    2017-07-18 医无止境。

    谢谢分享受益匪浅

    0

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    2017-07-18 152****8376

    谢谢分享受益匪浅

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