FDA批准替度鲁肽治疗成人短肠综合征

2012-12-25 FDA CMT 晓静 编译

12月21日,美国食品与药物管理局(FDA)批准了替度鲁肽(teduglutide)用于治疗需要额外胃肠外营养的成人短肠综合征(SBS)患者。 替度鲁肽是一种有助于改善肠道液体和营养物质吸收的注射剂,每日应用一次。该药是第三个FDA批准需要营养支持的成人SBS的治疗药物。其余两种药物——生长激素(somatropin)和谷氨酰胺(glutamine)分别于2003年和2004年获准。


12月21日,美国食品与药物管理局(FDA)批准了替度鲁肽(teduglutide)用于治疗需要额外胃肠外营养的成人短肠综合征(SBS)患者。

替度鲁肽是一种有助于改善肠道液体和营养物质吸收的注射剂,每日应用一次。该药是第三个FDA批准需要营养支持的成人SBS的治疗药物。其余两种药物——生长激素(somatropin)和谷氨酰胺(glutamine)分别于2003年和2004年获准。

接受替度鲁肽治疗的患者发生肠道癌症和息肉,肠梗阻,胆囊、胆道和胰腺疾病的潜在危险增加。为确保患者应用替度鲁肽的获益大于其潜在风险,FDA通过风险评估和减轻策略批准了该药。为研究替度鲁肽的长期安全性,FDA已要求厂家在常规临床环境下使SBS患者应用替度鲁肽的上市后研究,以进一步评估该药增加潜在致结直肠癌和其他疾病风险。该研究中的患者将随访至少10年。

两项临床试验和延伸试验评估了替度鲁肽的安全性、有效性和耐受性。试验中的患者被随机分为接受替度鲁肽治疗组和安慰剂组。评估治疗20—24周后每周胃肠外营养容量至少降低20%的患者数(临床反应)和治疗24周后胃肠外营养平均降低容量。结果显示,接受替度鲁肽治疗的患者中有46%和63%达到了临床反应,而安慰剂组的患者这一百分比为6%和30%。胃肠外营养在替度鲁肽治疗组平均降低了2.5 L/周和4.4 L/周,安慰剂组为0.9 L/周和2.3 L/周。

延伸试验随访了接受额外的28周替度鲁肽治疗的患者。结果显示,连续替度鲁肽治疗1年后患者胃肠外营养容量平均降低4.9 L/周和5.2 L/周。延伸试验中有6例患者在接受替度鲁肽治疗时摆脱了胃肠外营养支持治疗。

试验中接受替度鲁肽治疗的患者最常见的不良反应包括腹痛,注射部位反应,恶心,头痛,腹胀和上呼吸道感染。

FDA相关的拓展阅读:

英文链接:FDA approves Gattex to treat short bowel syndrome

   

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    2013-02-24 bugit
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