Arthritis Rheumatol:缓释和速释非布索坦对痛风肾损害患者的疗效和安全性

2018-08-06 xiangting MedSci原创

在肾功能正常或受损的痛风患者中,两种非布索坦制剂(XR和IR)均耐受良好并有效,其中包括严重肾功能不全患者。

这项研究旨在评估缓释(XR)和速释(IR)非布索坦对肾功能正常或受损痛风患者的疗效和安全性。

这是一项为期3个月的多中心III期安慰剂对照双盲研究;有痛风病史、肾功能正常或受损(轻至重度)的患者(n=1790)被随机分配为安慰剂组、非布索坦IR 40或80 mg、或非布索坦XR 40或80 mg每日一次(按照1:1:1 :1:1的比例)。终点包括以下患者的比例:3个月时血清尿酸(sUA)<5.0mg/dL(主要终点),3个月时sUA <6.0 mg/dL,和3个月内有≥1次需要治疗的痛风急性发作(次要终点)。

两种非布索坦制剂均使得更多的患者在第3个月时sUA<5.0mg/dL或sUA<6.0mg/dL(与安慰剂相比P均<0.001)。同等剂量的XR和IR非布索坦对sUA终点有相似疗效; 然而,与IR 40mg相比,使用XR 40 mg治疗患者达到sUA<5.0mg/dL的比例显著更大。不同治疗组间≥1次痛风发作的患者比例相似。治疗急性不良事件的发生率低,均匀分布在治疗组之间。预先计划的亚组分析表明,在所有肾功能亚组中两种非布索坦制剂均耐受良好,并对sUA终点(相对于安慰剂)普遍有效。

在肾功能正常或受损的痛风患者中,两种非布索坦制剂(XR和IR)均耐受良好并有效,其中包括严重肾功能不全患者。

原始出处:

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    2018-11-06 lq0313
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1972514, encodeId=99fa19e25149a, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Wed Dec 12 14:45:00 CST 2018, time=2018-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1754611, encodeId=385b1e54611a8, content=<a href='/topic/show?id=c781825606e' target=_blank style='color:#2F92EE;'>#肾损害#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82560, encryptionId=c781825606e, topicName=肾损害)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eaf036768149, createdName=lq0313, createdTime=Tue Nov 06 19:45:00 CST 2018, time=2018-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720869, encodeId=06791e208690f, content=<a href='/topic/show?id=634ee040179' target=_blank style='color:#2F92EE;'>#疗效和安全性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70401, encryptionId=634ee040179, topicName=疗效和安全性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16ef32982072, createdName=经常头晕, createdTime=Tue Apr 30 01:45:00 CST 2019, time=2019-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1700907, encodeId=acaa1e00907d7, content=<a href='/topic/show?id=7605993983e' target=_blank style='color:#2F92EE;'>#非布索坦#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99398, encryptionId=7605993983e, topicName=非布索坦)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=968830287714, createdName=wetgdt, createdTime=Fri Nov 02 18:45:00 CST 2018, time=2018-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=344259, encodeId=b42734425938, content=学习了,谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Mon Sep 10 07:49:59 CST 2018, time=2018-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356877, encodeId=661613568e7bd, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed Aug 08 06:45:00 CST 2018, time=2018-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031870, encodeId=9b7f10318e05e, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Mon Aug 06 18:45:00 CST 2018, time=2018-08-06, status=1, ipAttribution=)]
    2018-09-10 1e145228m78(暂无匿称)

    学习了,谢谢作者分享!

    0

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    2018-08-08 zhaojie88
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    2018-08-06 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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2017年11月,美国FDA向公众通报了武田制药治疗高尿酸痛风症的药物Uloric(febuxostat,非布索坦)的安全临床试验初步结果。Uloric是一种全新高效的非嘌呤类黄嘌呤氧化酶选择性抑制剂,可以降低高尿酸血症痛风患者血液中的尿酸水平,而不抑制其他参与尿酸通路的酶,因此安全性相比别嘌醇更高。但上市前临床试验结果显示,Uloric所致的心脏相关性不良反应的发病率高于别嘌醇,因此FDA在其说

这3种药,竟会诱发高尿酸?

通过医生的建议,新闻电视广播等传媒的科普,一部分人对于如何治疗高尿酸血症以及相关的一些日常注意事项,还是知道一点的。但用药不慎,可能会使尿酸升高,诱发高尿酸血症这一点,却是大部分人都知之甚微的。

痛风发作痛苦不堪?小心这诱发痛风发作的12个坑!

痛风急性发作是怎么一回事?简而言之,这是由于尿酸在人体内水溶性很差,在多种诱发因素的影响下(尿酸波动、寒冷、体内PH值等),痛风患者体内原来已经接近饱和的尿酸,加速进入软组织形成结晶,导致身体免疫系统过度反应而造成急性炎症反应的过程。

CMAJ:痛风和骨折之间 降尿酸治疗有意义吗?

近年来,我国痛风的发病率逐年上升。痛风是否增加骨折风险,疾病早期给予降尿酸药物对长期骨折风险是否有益,既往研究结果冲突。2018年5月,发表在《CMAJ》的一项研究调查了痛风患者脆性骨折风险和降尿酸治疗的作用。