NEJM:普拉格雷对镰状细胞性贫血患者血管阻塞性危象无效

2015-12-08 catxa2016译 MedSci原创

镰状细胞性贫血是一种遗传性血液系统疾病,易并发血管阻塞性危象(VOC),相应治疗方案极少。镰状细胞性贫血发生VOC时,血小板调节细胞间粘附和血栓形成,暗示抗血小板药物可以缓解VOC。研究者纳入了2-17岁的镰状细胞性贫血患者,随机分为口服普拉格雷和安慰剂9-24个月。初始结局指标为VOC发生率,继发结局指标为镰状细胞相关疼痛以及疼痛频率。研究共纳入了13个国家341名患者,普拉格雷组和安慰剂组VO

镰状细胞性贫血是一种遗传性血液系统疾病,易并发血管阻塞性危象(VOC),相应治疗方案极少。镰状细胞性贫血发生VOC时,血小板调节细胞间粘附和血栓形成,暗示抗血小板药物可以缓解VOC。

研究者纳入了2-17岁的镰状细胞性贫血患者,随机分为口服普拉格雷和安慰剂9-24个月。初始结局指标为VOC发生率,继发结局指标为镰状细胞相关疼痛以及疼痛频率。

研究共纳入了13个国家341名患者,普拉格雷组和安慰剂组VOC发生率分别为2.30/人年和2.77/人年(RR 0.83; 95% CI 0.66 to 1.05; P=0.12)。继发性结局指标在两组间无差异。需医疗干预的出血事件、出血性或非出血性不良事件、中止治疗等在两组间无差异。

研究结果表明,对镰状细胞性贫血的儿童和青少年,口服普拉格雷并不会降低VOC发生率(与安慰剂组相比)。关于安全性在两组见也无差异。

原始出处:


Matthew M. Heeney,Carolyn C. Hoppe, et al.A Multinational Trial of Prasugrel for Sickle Cell Vaso-Occlusive Events.NEJM December 8, 2015

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    2016-11-18 tomyang96
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