NEJM:利福喷丁-莫西沙星4个月治疗方案用于结核病的治疗

2021-05-06 MedSci原创 MedSci原创

4个月的利福喷丁-异烟肼-吡嗪酰胺-莫西沙星抗结核治疗方案与6个月的利福平-异烟肼-吡嗪酰胺-乙胺丁醇标准治疗的临床效果相当

目前,结核病高效治疗方案可使治疗时间缩短到6个月,大大提高了患者的治疗依从性,降低潜在的药物副作用和治疗成本。利福霉素类抗生素,如利福平、利福喷汀及利福布汀,是治疗结核病的重要组成。模型研究以及先前的II期临床研究显示,对于利福霉素类抗生素敏感的患者,其疗程有望进一步缩短。近日研究人员开展III期临床研究,考察了利福霉素类抗生素对结核患者的治疗效果。

来自13个国家的新诊断肺结核患者参与研究,比较了2种4个月的以利福喷丁为基础的治疗方案与标准的6个月利福平-异烟肼-吡嗪酰胺-乙胺丁醇(对照组)方案的疗效差异,在2个不同的利福喷丁方案中,其一以利福喷丁代替利福平,其他药物不变,另一个以利福喷丁代替利福平的同时以莫西沙星代替乙胺丁醇,其他药物不变。研究的主要疗效指标为12个月无肺结核生存率。

2343名结核分枝杆菌培养阳性,且对异烟肼、利福平或氟喹诺酮类药物不耐药的患者参与分组,其中对照组768例,利福喷丁-莫西沙星组791例,利福喷丁组784例,194人同时感染了人类免疫缺陷病毒,1703例为空洞型肺结核。研究发现,利福喷丁-莫西沙星组的治疗效果与对照组相当(不良预后率:15.5% vs 14.6%),次要终点和敏感性分析均达到非劣性终点,但利福喷丁组的治疗效果劣于对照(17.7% vs 14.6%)。3级及以上不良事件发生率,对照组为19.3%,利福喷丁-莫西沙星组为18.8%,利福喷丁组为14.3%。

研究认为,4个月的利福喷丁-异烟肼-吡嗪酰胺-莫西沙星抗结核治疗方案与6个月的利福平-异烟肼-吡嗪酰胺-乙胺丁醇标准治疗的临床效果相当

原始出处:

Susan E. Dorman et al. Four-Month Rifapentine Regimens with or without Moxifloxacin for Tuberculosis. N Engl J Med, May 06, 2021.

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    2021-07-09 随风1991

    剂量?

    0

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    2021-05-07 小小医者

    #利福喷丁#-#莫西沙星#治疗#结核病#,4个月短程方案

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1905164, encodeId=917b1905164bc, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Mon Aug 16 00:14:13 CST 2021, time=2021-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=997778, encodeId=8f9899e77870, content=剂量?, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2020/02/20/44e485222679b3a7b0d5676ca7443126.jpg, createdBy=ef735089224, createdName=随风1991, createdTime=Fri Jul 09 08:40:01 CST 2021, time=2021-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1254394, encodeId=10671254394a9, content=<a href='/topic/show?id=f30ae86297d' target=_blank style='color:#2F92EE;'>#结核#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78629, encryptionId=f30ae86297d, topicName=结核)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Sat May 08 09:14:13 CST 2021, time=2021-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=963308, encodeId=9835963308ba, content=<a href='/topic/show?id=a0301042e2bb' target=_blank style='color:#2F92EE;'>#利福喷丁#</a>-<a href='/topic/show?id=6b1b8e9908a' target=_blank style='color:#2F92EE;'>#莫西沙星#</a>治疗<a href='/topic/show?id=391de865327' target=_blank style='color:#2F92EE;'>#结核病#</a>,4个月短程方案, beContent=null, objectType=article, channel=null, level=null, likeNumber=161, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104272, encryptionId=a0301042e2bb, topicName=利福喷丁), TopicDto(id=87990, encryptionId=6b1b8e9908a, topicName=莫西沙星), TopicDto(id=78653, encryptionId=391de865327, topicName=结核病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=小小医者, createdTime=Fri May 07 09:16:35 CST 2021, time=2021-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035638, encodeId=959110356389e, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu May 06 21:14:13 CST 2021, time=2021-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=963185, encodeId=f4b8963185d3, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu May 06 19:51:36 CST 2021, time=2021-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=963162, encodeId=9858963162c1, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Thu May 06 19:03:13 CST 2021, time=2021-05-06, status=1, ipAttribution=)]
    2021-05-06 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1905164, encodeId=917b1905164bc, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Mon Aug 16 00:14:13 CST 2021, time=2021-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=997778, encodeId=8f9899e77870, content=剂量?, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2020/02/20/44e485222679b3a7b0d5676ca7443126.jpg, createdBy=ef735089224, createdName=随风1991, createdTime=Fri Jul 09 08:40:01 CST 2021, time=2021-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1254394, encodeId=10671254394a9, content=<a href='/topic/show?id=f30ae86297d' target=_blank style='color:#2F92EE;'>#结核#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78629, encryptionId=f30ae86297d, topicName=结核)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Sat May 08 09:14:13 CST 2021, time=2021-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=963308, encodeId=9835963308ba, content=<a href='/topic/show?id=a0301042e2bb' target=_blank style='color:#2F92EE;'>#利福喷丁#</a>-<a href='/topic/show?id=6b1b8e9908a' target=_blank style='color:#2F92EE;'>#莫西沙星#</a>治疗<a href='/topic/show?id=391de865327' target=_blank style='color:#2F92EE;'>#结核病#</a>,4个月短程方案, beContent=null, objectType=article, channel=null, level=null, likeNumber=161, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104272, encryptionId=a0301042e2bb, topicName=利福喷丁), TopicDto(id=87990, encryptionId=6b1b8e9908a, topicName=莫西沙星), TopicDto(id=78653, encryptionId=391de865327, topicName=结核病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=小小医者, createdTime=Fri May 07 09:16:35 CST 2021, time=2021-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035638, encodeId=959110356389e, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu May 06 21:14:13 CST 2021, time=2021-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=963185, encodeId=f4b8963185d3, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu May 06 19:51:36 CST 2021, time=2021-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=963162, encodeId=9858963162c1, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Thu May 06 19:03:13 CST 2021, time=2021-05-06, status=1, ipAttribution=)]
    2021-05-06 jyzxjiangqin

    好文章!

    0

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    2021-05-06 wxl882001

    了解

    0

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