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Ther Drug Monit:高剂量的利巴韦林能加强丙型肝炎患者早期病毒学反应

2015-03-31 范伟译 MedSci原创

背景:该研究的目的是调查患者先前采用利巴韦林标准护理(SOC)治疗无反应,根据体重是否加大利巴韦林的剂量会有反应,通过管理巴韦林达到个性化的剂量。 方法:先前无反应的标准护理治疗是采用干扰素(peg-IFN)和利巴韦林。利巴韦林的剂量达到血浆浓度>15µmol/L。最初的利巴韦林剂量计算公式是根据肾功能和体重得到的。红细胞生成素治疗先于抗病毒治疗两周。 结果:20例(16男4女)平均年龄

背景:该研究的目的是调查患者先前采用利巴韦林标准护理(SOC)治疗无反应,根据体重是否加大利巴韦林的剂量会有反应,通过管理巴韦林达到个性化的剂量。

方法:先前无反应的标准护理治疗是采用干扰素(peg-IFN)和利巴韦林。利巴韦林的剂量达到血浆浓度>15µmol/L。最初的利巴韦林剂量计算公式是根据肾功能和体重得到的。红细胞生成素治疗先于抗病毒治疗两周。

结果:20例(16男4女)平均年龄52岁的患者包括在内。60%的患者有晚期的纤维化。治疗24周后,80%的患者获得早期病毒反应,60%的患者的丙型肝炎病毒核糖核酸(HCV RNA)为阴性。在第12周,高剂量的利巴韦林使HCV RNA的下降值显著增加(平均3.13国际单位/毫升vs平均2.05国际单位/毫升;p<0.001)。9例患者的HCV RNA为阴性达到治疗终点,1例获得持续的病毒(SVR)反应。最后稳定状态为每天服用利巴韦林从1400到4400毫克的剂量。治疗期间,血红蛋白水平下降了,即第0周,第4周,第12周Hb为163,134和110 g/L。两个患者接受输血。无其它严重不良反应记录。

结论: 个性化的高剂量的利巴韦林相比于标准剂量的利巴韦林方案使早期病毒性丙肝病毒核糖核酸值下降更明显。这个方案通过对贫血进行密切监测,并与红细胞生成素协同治疗表明是安全的。

原始出处

Lindahl K1, Hörnfeld E, Ståhle L, Carlsson T, Weiland O, Parke Å, Schvarcz R. High Dose Ribavirin Enhances Early Virological Response in Hepatitis C Genotype 1 Infected Patients. Ther Drug Monit. 2015 Mar 24.

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    2016-01-13 amy0550
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    2016-03-13 爆笑小医
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1942047, encodeId=a7db194204e40, content=<a href='/topic/show?id=065b1022341a' target=_blank style='color:#2F92EE;'>#高剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102234, encryptionId=065b1022341a, topicName=高剂量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=010d202, createdName=amy0550, createdTime=Wed Jan 13 08:30:00 CST 2016, time=2016-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1862230, encodeId=ff89186223008, content=<a href='/topic/show?id=1f0e626267' target=_blank style='color:#2F92EE;'>#Drug#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6262, encryptionId=1f0e626267, topicName=Drug)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Sun Mar 13 06:30:00 CST 2016, time=2016-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1807809, encodeId=d011180e809bc, content=<a href='/topic/show?id=dd7d8124144' target=_blank style='color:#2F92EE;'>#肝炎患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81241, encryptionId=dd7d8124144, topicName=肝炎患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cd0d217, createdName=huiwelcome, createdTime=Mon Aug 24 13:30:00 CST 2015, time=2015-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1274556, encodeId=de7e12e4556ef, content=<a href='/topic/show?id=30872089e03' target=_blank style='color:#2F92EE;'>#丙型肝炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20897, encryptionId=30872089e03, topicName=丙型肝炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f503121, createdName=zjubiostat, createdTime=Thu Apr 02 02:30:00 CST 2015, time=2015-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360295, encodeId=b40d136029502, content=<a href='/topic/show?id=61073229696' target=_blank style='color:#2F92EE;'>#利巴韦林#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32296, encryptionId=61073229696, topicName=利巴韦林)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=08e4137, createdName=meichuangyi, createdTime=Thu Apr 02 02:30:00 CST 2015, time=2015-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603323, encodeId=05d7160332379, content=<a href='/topic/show?id=4800e091642' target=_blank style='color:#2F92EE;'>#病毒学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70916, encryptionId=4800e091642, topicName=病毒学)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ed319029923, createdName=周虎, createdTime=Thu Apr 02 02:30:00 CST 2015, time=2015-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=19128, encodeId=acef1912854, content=有意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2c8e1619533, createdName=cd90, createdTime=Tue Mar 31 11:47:00 CST 2015, time=2015-03-31, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1942047, encodeId=a7db194204e40, content=<a href='/topic/show?id=065b1022341a' target=_blank style='color:#2F92EE;'>#高剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102234, encryptionId=065b1022341a, topicName=高剂量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=010d202, createdName=amy0550, createdTime=Wed Jan 13 08:30:00 CST 2016, time=2016-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1862230, encodeId=ff89186223008, content=<a href='/topic/show?id=1f0e626267' target=_blank style='color:#2F92EE;'>#Drug#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6262, encryptionId=1f0e626267, topicName=Drug)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Sun Mar 13 06:30:00 CST 2016, time=2016-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1807809, encodeId=d011180e809bc, content=<a href='/topic/show?id=dd7d8124144' target=_blank style='color:#2F92EE;'>#肝炎患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81241, encryptionId=dd7d8124144, topicName=肝炎患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cd0d217, createdName=huiwelcome, createdTime=Mon Aug 24 13:30:00 CST 2015, time=2015-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1274556, encodeId=de7e12e4556ef, content=<a href='/topic/show?id=30872089e03' target=_blank style='color:#2F92EE;'>#丙型肝炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20897, encryptionId=30872089e03, topicName=丙型肝炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f503121, createdName=zjubiostat, createdTime=Thu Apr 02 02:30:00 CST 2015, time=2015-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360295, encodeId=b40d136029502, content=<a href='/topic/show?id=61073229696' target=_blank style='color:#2F92EE;'>#利巴韦林#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32296, encryptionId=61073229696, topicName=利巴韦林)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=08e4137, createdName=meichuangyi, createdTime=Thu Apr 02 02:30:00 CST 2015, time=2015-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603323, encodeId=05d7160332379, content=<a href='/topic/show?id=4800e091642' target=_blank style='color:#2F92EE;'>#病毒学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70916, encryptionId=4800e091642, topicName=病毒学)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ed319029923, createdName=周虎, createdTime=Thu Apr 02 02:30:00 CST 2015, time=2015-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=19128, encodeId=acef1912854, content=有意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2c8e1619533, createdName=cd90, createdTime=Tue Mar 31 11:47:00 CST 2015, time=2015-03-31, status=1, ipAttribution=)]
    2015-04-02 周虎
  7. [GetPortalCommentsPageByObjectIdResponse(id=1942047, encodeId=a7db194204e40, content=<a href='/topic/show?id=065b1022341a' target=_blank style='color:#2F92EE;'>#高剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102234, encryptionId=065b1022341a, topicName=高剂量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=010d202, createdName=amy0550, createdTime=Wed Jan 13 08:30:00 CST 2016, time=2016-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1862230, encodeId=ff89186223008, content=<a href='/topic/show?id=1f0e626267' target=_blank style='color:#2F92EE;'>#Drug#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6262, encryptionId=1f0e626267, topicName=Drug)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Sun Mar 13 06:30:00 CST 2016, time=2016-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1807809, encodeId=d011180e809bc, content=<a href='/topic/show?id=dd7d8124144' target=_blank style='color:#2F92EE;'>#肝炎患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81241, encryptionId=dd7d8124144, topicName=肝炎患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cd0d217, createdName=huiwelcome, createdTime=Mon Aug 24 13:30:00 CST 2015, time=2015-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1274556, encodeId=de7e12e4556ef, content=<a href='/topic/show?id=30872089e03' target=_blank style='color:#2F92EE;'>#丙型肝炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20897, encryptionId=30872089e03, topicName=丙型肝炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f503121, createdName=zjubiostat, createdTime=Thu Apr 02 02:30:00 CST 2015, time=2015-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360295, encodeId=b40d136029502, content=<a href='/topic/show?id=61073229696' target=_blank style='color:#2F92EE;'>#利巴韦林#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32296, encryptionId=61073229696, topicName=利巴韦林)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=08e4137, createdName=meichuangyi, createdTime=Thu Apr 02 02:30:00 CST 2015, time=2015-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603323, encodeId=05d7160332379, content=<a href='/topic/show?id=4800e091642' target=_blank style='color:#2F92EE;'>#病毒学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70916, encryptionId=4800e091642, topicName=病毒学)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ed319029923, createdName=周虎, createdTime=Thu Apr 02 02:30:00 CST 2015, time=2015-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=19128, encodeId=acef1912854, content=有意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2c8e1619533, createdName=cd90, createdTime=Tue Mar 31 11:47:00 CST 2015, time=2015-03-31, status=1, ipAttribution=)]
    2015-03-31 cd90

    有意义

    0

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