• tsamba_banner

Nkhani

Malinga ndi kafukufuku wopangidwa mwachisawawa ku Europe, chithandizo chamakono cholowa m'malo mwachitsulo chinapangitsa kuti pakhale kuchuluka kwa hypophosphatemia mwa odwala omwe ali ndi vuto la kuchepa kwa magazi m'matumbo (IBD), ngakhale amafanana ndi hemoglobin ndi masitolo achitsulo.
Heinz Zoller, MD, akunena kuti mu phunziro la PHOSPHARE-IBD ​​la odwala 97 IBD omwe ali ndi vuto la kuchepa kwa magazi m'thupi la iron carboxymaltose (FCM; Injectafer) motsutsana ndi iron demethylmaltose (FDI; Monoferric).apamwamba mwa odwala., Medical University of Innsbruck, Austria, ndi anzawo.
Kuyambira pachiyambi mpaka tsiku la 35, 51% ya odwala FCM ndi 8.3% ya odwala FDI anali ndi hypophosphatemia nthawi iliyonse, monga umboni wa serum phosphate milingo yochepera 2.0 mg/dL (kusiyana kwachiwopsezo - 42.8, 95% CI -57.1 mpaka -24.6 )., P<0,0001), — написала группа в Gut. , P<0.0001), gululo linalemba mu Gut.
Ofufuzawo adagwiritsa ntchito milingo yofananira yotengera hemoglobin ndi kulemera kwa thupi pazogulitsa zonse ziwiri kuti aletse zinthu zomwe zingasokoneze m'mayesero am'mbuyomu. Chiwopsezo chachikulu cha hypophosphatemia chinachitika mkati mwa masabata awiri oyamba a kulowetsedwa, ndipo adakhalabe mgulu la FCM pamasiku 70 (59.2% vs 12.5%, P<0.0001). Chiwopsezo chachikulu cha hypophosphatemia chinachitika mkati mwa masabata awiri oyamba a kulowetsedwa, ndipo adakhalabe mgulu la FCM pamasiku 70 (59.2% vs 12.5%, P<0.0001). Самая высокая частота гипофосфатемии возникла в течение первых 2 недель инфузии и оставалась повышенной в группе FCM через 70 дней (59,2% против 12,5%, P<0,0001). Chiwopsezo chachikulu cha hypophosphatemia chinachitika m'masabata awiri oyamba a kulowetsedwa ndipo adakhalabe mgulu la FCM patatha masiku 70 (59.2% vs 12.5%, P<0.0001).低磷血症的最高发生率发生在输注的前2 周内,并且在FCM 组在70 天时仍然升高(59.20% vs 12.低磷血症的最高发生率发生在输注的前2 周内,并且在FCM 组在70 天时仍然升高(59.00% vs 12.5% ​​vs 12. Самая высокая частота гипофосфатемии возникла в течение первых 2 недель инфузии и оставалась повышенной в тегний 20, п5, 10, п5, 10, 10, 10, 10, 10, 10, 10, 20, 10, 10, 10, 10, 10, 5, 10, 10, 10, 10, 5, 10. Chiwopsezo chachikulu cha hypophosphatemia chinachitika m'masabata awiri oyambirira a kulowetsedwa ndipo anakhalabe okwera kwa masiku 70 mu gulu la FCM (59.2% vs 12.5%, P<0.0001).
"Ngakhale kuti zimakhala zogwira mtima komanso palibe kusiyana kwa ziwengo, mankhwala awiri omwe amagwiritsidwa ntchito kwambiri masiku ano ku Ulaya ali ndi chitetezo chodziwika bwino, monga chitsulo cha desmethylmaltose chingatengedwe ngati kukonzekera bwino," Zoller anauza MedPage Today.
Iron Deficiency anemia ndi vuto lodziwika bwino la IBD lomwe limatha kusokoneza magwiridwe antchito amthupi komanso chidziwitso ndikuwonjezera chiwopsezo chogonekedwa m'chipatala.Monga tanenera kale, FCM ndi FDI zinasonyeza mphamvu zofanana pokonza kuchepa kwa magazi m'thupi ndi pafupifupi kuwonjezeka kofanana kwa hemoglobin pambuyo pa masiku 70 (25.2 ndi 24.9 g / l, motsatira).
Kusiyana kwa zochitika za hypophosphatemia pakati pa mankhwala awiri olowa m'malo mwa chitsulo omwe adawonedwa m'mbuyomu kunafotokozedwa pang'onopang'ono ndi kuuma kapena chifukwa cha kuchepa kwa chitsulo, momwe aimpso amagwirira ntchito, komanso mitundu yosiyanasiyana yamankhwala amitsempha yamagazi..Chiyeso cham'mbuyomu chosasinthika kuyerekeza njira ziwiri zochizira chitsulo, kuyesa kwa US PHOSPHARE-IDA, kudawonetsanso kuchuluka kwa hypophosphatemia mu FCM, ngakhale kuti mlingo ndi ndandanda wa dosing zimasiyanasiyana malinga ndi chidziwitso chovomerezeka ndi FDA.
"Kafukufuku waposachedwa adawonetsanso kuti, ngakhale atachira ku hypophosphatemia, kusinthika kwachilengedwe kwachilengedwe komwe kumalumikizidwa ndi mawonekedwe apamwamba a FGF23 [fibroblast growth factor 23], yotchedwa "6H syndrome", sikudalira odwala omwe amalandira FCM," Zoller.ndi anzake analemba.
"Makamaka, mafupa enieni [alkaline phosphatase] adakhalabe okwera mu gulu la FCM poyerekeza ndi gulu la FDI pa tsiku la 70, kutanthauza kuti FCM inakhudza kusintha kwa mafupa panthawi yonse ya mayesero ndi kupitirira," iwo anapitiriza."Kupeza uku kungaphatikizepo hypophosphatemia ndi osteomalacia, vuto lomwe likukula la FCM lomwe posachedwapa lidalembedwa ngati chenjezo lapadera pazambiri zaku Europe kwa odwala omwe ali ndi FCM."
Zoller adauza MedPage Today kuti kafukufuku wowonjezera "akuyang'ana kumvetsetsa chifukwa chake mankhwalawa amasiyana pakulowetsa FGF23, timadzi timene timayambitsa kuyankha kovutirapo komwe kumayambitsa hypophosphatemia, kupewa kukula kwamankhwala kwamtsogolo."Kukhala ndi zotsatirapo izi ndikumvetsetsa kusokonekera uku. ”.”
PHOSPHARE-IBD ​​​​ndi kuyesa kwapawiri, kosasinthika kwa odwala 97 IBD - 61% omwe ali ndi ulcerative colitis (UC) ndi 39% omwe ali ndi matenda a Crohn's (CD) - m'zipatala 20 zaku Europe kuyambira 2018. 2020.
Odwala oyenerera ankafuna mlingo wa ferritin wa seramu wa 100 ng / mL kapena wotsika, mlingo wa hemoglobini wocheperapo 130 g / L, ndipo unkafunika kuwonjezereka kwachitsulo chofulumira kapena kukhala ndi kusagwirizana kwachitsulo mkamwa / kusakhudzidwa, pakati pa njira zina.
Ophunzirawo adasankhidwa mwachisawawa mu chiwerengero cha 1: 1 kuti alandire mlingo womwewo wa FDI kapena FCM pogwiritsa ntchito hemoglobini ndi kulemera kwa thupi poyambira ndi masiku 35 pambuyo pake.Kwa odwala omwe ali ndi hemoglobini yochepera 100 g / l, mlingo wonse ndi 1500 mg kwa odwala osakwana 70 kg ndi 2000 mg kwa odwala omwe amalemera 70 kg kapena kupitilira apo.Odwala omwe ali ndi mlingo wa hemoglobin wa 100 g/l ndi kupitirira apo analandira mlingo wa 1500 mg.
Zoller ndi anzake adalemba kuti: "Poganizira momwe phunziroli linapangidwira, tinganene kuti kusiyana komwe kunachitika muzochitika za hypophosphatemia ndi chifukwa cha kusiyana kwa kukonzekera kwachitsulo, osati ku chiwerengero cha chitsulo, mlingo wa mankhwala, kusiyana kwa CD. poyerekeza ndi UC.kapena zinthu zina zokhudzana ndi odwala monga ntchito ya impso, kuopsa kwa kutupa, kuchepa kwachitsulo, kapena kuchepa kwa vitamini D.
Zaka zapakati za odwala mu phunziroli zinali zaka 42, 53% anali akazi, ambiri anali oyera (86%), ndipo chiwerengero cha thupi chinali 27.6.Mulingo wamba wa hemoglobin woyambira ndi 105 g / l.
Kuchuluka kwa zochitika zoyipa (AEs) ndi zochitika zoyipa kwambiri (AEs) zinali zofanana ndi zinthu zosiyanasiyana, koma zambiri zinali zofatsa (80-83%).Gulu la FCM linali ndi kusowa kwa vitamini D (35% vs 23%) komanso milandu yambiri ya nasopharyngitis (20% vs 17%) kuposa gulu la FDI.Mu gulu la FDI, mutu (19% vs. 10%) unali wofala kwambiri, monga momwe zinalili ndi nseru (13% vs. 2%).Odwala ambiri mu gulu la FDI anasiya kulandira chithandizo chifukwa cha ma AEs (6% vs 2%).
Ngakhale kuti zonsezi zinapangitsa kuti chiwerengero cha kutopa cha odwala chiwonjezeke, kusintha kwakukulu komanso kofulumira kunawoneka mu gulu la FDI, ngakhale kuti kusiyana kumeneku kunataya kufunikira pambuyo pa masiku a 70.
Zolepheretsa deta zimaphatikizapo nthawi yochepa yotsatila komanso kulephera kuyesa bwinobwino zotsatira zachipatala.
Zaina Hamza ndi MedPage Masiku ano wolemba ndodo wa gastroenterology ndi matenda opatsirana.Iye amakhala ku Chicago.
Zoller adalengeza zandalama kuchokera ku Abbvie, Bayer, Falk, Gileadi, Merz, Medice, Pierre Fabre, Pharmacosmos, Sanofi ndi Vifor.Olemba nawo amafotokoza za ubale ndi makampani angapo azamankhwala ndi mafakitale.Wolemba nawonso adanenanso za olemba anzawo ma patent okhudzana ndi kukonzekera kwachitsulo cha parenteral.
KULUMIKIZANA KWA SOURCE: Zoller H et al."Hypophosphatemia pambuyo poyendetsa iron desferiomaltose ndi iron carboxymaltose kwa odwala omwe ali ndi vuto la kuchepa kwa magazi m'thupi chifukwa cha matenda opweteka a m'mimba (Phosphare-IBD): kuyesedwa kwachipatala kosasinthika" Gut 2022;DOI: 10.1136/gutjnl-2022-327897.
Zomwe zili pa webusayitiyi ndizongodziwa zambiri zokha ndipo sizilowa m'malo mwa upangiri wamankhwala, matenda, kapena chithandizo chochokera kwa dokotala wodziwa bwino ntchito zachipatala.© 2022 MedPage Today LLC.Maumwini onse ndi otetezedwa.Medpage Today ndi chimodzi mwa zidziwitso zolembetsedwa ndi boma za MedPage Today, LLC ndipo sizingagwiritsidwe ntchito ndi anthu ena popanda chilolezo.


Nthawi yotumiza: Sep-23-2022