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NEJM:Donidalorsen可降低遗传性血管性水肿发作风险改善患者生活质量

2022-03-17 zhangfan MedSci原创

这项遗传性血管性水肿患者参与的小规模II期试验中,Donidalorsen治疗可显著降低患者血管性水肿发作率,提高生活质量

遗传性血管性水肿(HAE)是一种罕见疾病,其病因是患者血清中C1脂酶抑制因子减少或功能缺损,以致C1过度活化,C4、C2的裂解失控,所生成的补体激肽增多,微血管通透性增高。大多数遗传性血管性水肿病例是由C1酯酶抑制因子水平降低(I型)或功能降低(II型)引起。反义寡核苷酸Donidalorsen是一款潜在“best-in-class”的遗传性血管性水肿预防疗法,可通过选择性抑制前激肽释放酶降低HAE发作频率和疾病负担。

在近期开展的II期临床研究中,C1缺乏抑制的遗传性血管水肿患者,接受4次Donidalsen (80mg)或安慰剂治疗,每4周一次。主要终点是在第1周(基线)到第17周血管性水肿发作率。次要终点包括血管性水肿生活质量得分(0-100之间,得分越高表明生活质量越差)和安全性。

20名患者参与研究,14人接受Donidalorsen治疗,6例接受安慰剂治疗。在接受Donidalorsen治疗的患者中,经确认的血管性水肿月平均发生率为0.23次,安慰剂组为2.21(平均差异:−90%)。从基线检查到第17周,血管性水肿生活质量问卷评分平均变化为:Donidalorsen组−26.8分,安慰剂组得−6.2分(平均差异:−20.7分)。在接受Donidalorsen治疗的患者中,轻中度不良事件的发生率为71%,安慰剂组为83%。

Donidalorsen治疗后水肿发作风险显著降低

这项遗传性血管性水肿患者参与的小规模II期试验中,Donidalorsen治疗可显著降低患者血管性水肿发作率,提高生活质量。

原始出处:

Lauré M. Fijen et al. Inhibition of Prekallikrein for Hereditary Angioedema. N Engl J Med,March 17, 2022.

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    2022-03-19 小华子
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IONIS-PKKRx和IONIS-PKK-LRx是研究性反义药物,旨在减少前激肽释放酶的产生。

Lancet:Garadacimab可有效预防C1酯酶抑制剂缺乏性遗传性血管性水肿患者的水肿发作

Garadacimab可显著降低 C1 酯酶抑制剂缺乏性遗传性血管性水肿患者的水肿发作,而且耐受性良好。

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