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Lancet:艾塞那肽对帕金森病的治疗效果。

2017-08-04 qinqiyun MedSci原创

Exenatide(艾塞那肽),胰高血糖素样肽-1(GLP-1)受体激动剂,对帕金森病的临床潜伏期模型有神经保护作用,艾塞那肽对确诊帕金森病患者有怎样的效果呢?

背景:Exenatide(艾塞那肽),胰高血糖素样肽-1(GLP-1)受体激动剂,对帕金森病的临床潜伏期模型有神经保护作用,Dilan AThauda及其同事对艾塞那肽在临床试验中是否有同样的效果进行探究。

方法:研究人员在一个独立中心进行随机化、双盲、安慰剂为对照的试验,将中度帕金森病患者(按1:1)随机分为两组,在其原来定期医疗基础上,分别每周接予以一次皮下注射2mg艾塞那肽或安慰剂,持续48周,随后12周清除期。纳入患者年龄在25-75岁,自发性帕金森病,均在接受多巴胺治疗,且有效果减退表现。主要评估结局是60周时去药物状态下运动障碍社会统一帕金森病评定量表(MDS-UPDRS)里运动评分(第3部分)的校准差。

结果:2014年6月18日-2015年3月13日,62名患者参与试验,经随机分组,32名在艾塞那肽组,30名在安慰剂组。分析时各剔除一名患者。60周时,MDS-UPDRS的第3部分去药物评分,艾塞那肽组提高1分(95% CI -2.6-0.7)、安慰剂组恶化2.1分(-0.6-4.8),校准平均差-3.5分(-6.7-[-0.3];p=0.0318)。注射点反应和胃肠道症状在两组中均有出现。艾塞那肽组出现6例严重副反应、安慰剂组出现2次,但均与研究干预无关。

分析:艾塞那肽对帕金森病的去药物运动评分有一定积极疗效,且持续效果超过暴露时间。但尚不确定艾塞那肽是影响了疾病的病理过程还是只单纯诱导长效症状效应。研究提示艾塞那肽给帕金森病研究提供一种新方式,但其对日常症状的影响应进一步进行长期试验来深入研究。

原始出处:

Dilan Athauda,Kate maclagan,et al.Exenatide once weekly versus placebo in Parkinson's disease: a randomised, double-blind, placebo-controlled trial.The Lancet.August 03,2017.http://dx.doi.org/10.1016/S0140-6736(17)31585-4.

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    2018-01-23 howi
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    2017-08-07 虈亣靌

    学习了受益匪浅。

    0

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    2017-08-05 QQ25ed180f

    临床用药较少~

    0

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    2017-08-04 虈亣靌

    不错的,学习了!谢谢分享!

    0

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    2017-08-04 baihao215

    great,值得期待

    0

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