Lancet:Veverimer可显著改善慢性肾病代谢性酸中毒患者症状

2019-06-26 MedSci MedSci原创

研究认为,慢性肾病、代谢性酸中毒患者中,veverimer可安全、有效地纠正代谢酸中毒,改善主客观的生理功能

代谢性酸中毒是慢性肾脏疾病的一种并发症,可引起蛋白质分解和骨脱钙,并与肾脏不良后果和死亡有关。Veverimer是一种非吸收,无反离子聚合性药物,可选择性地结合并去除肠道腔中的盐酸。

近日研究人员开展为期40周的、多中心、随机、盲目、安慰剂对照研究。慢性肾病患者(肾小球滤过率为20~40 mL/min/1.73 m 2)和代谢性酸中毒患者(血清碳酸氢盐浓度为12-20 mmol/L),随机接受veverimer(6克/天)或安慰剂。研究的主要终点是安全性;四个次要终点评估了veverimer对血清碳酸氢盐浓度和生理功能的长期影响。

217名患者参与研究(124名被随机分配到veverimer组,93名被随机分配到安慰剂组),其中196名患者(114名veverimer,82名安慰剂)完成了为期40周的扩展研究。与安慰剂相比,veverimer治疗早期停止率较低(分别为3%和10%),无因不良事件而停止治疗的患者。veverimer治疗的患者中有2%发生严重不良事件,安慰剂治疗的患者中有5%发生严重不良事件(其中2人死亡)。veverimer组和安慰剂组分别报告了8%和15%的肾系统不良事件。与安慰剂组相比,veverimer治疗组52周时碳酸氢钠(≥4 mmol/L或正常化)升高比例较大(63% vs 38%),治疗第1周起各时间点均观察到高于安慰剂的碳酸氢盐浓度(p<0.0 0 1)。vevermer改善了患者生理功能,与安慰剂相比,肾脏疾病与生活质量评分改善12.1。椅架测试时间在veverimer组提高了4.3s,安慰剂组提高了1.4s。

研究认为,慢性肾病、代谢性酸中毒患者中,veverimer可安全、有效地纠正代谢酸中毒,改善主客观的生理功能。

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    2020-01-13 howi
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    2020-05-26 sodoo
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    2019-06-28 mashirong