Amakuru

Nk’uko ubushakashatsi bwakozwe ku mugabane w’uburayi bwabigaragaje, uburyo bwo kuvura ibyuma bugezweho bwo gusimbuza ibyuma byaviriyemo indwara ya hypophosphatemia ku barwayi bafite ikibazo cyo kubura amaraso make afitanye isano n’indwara zifata amara (IBD), nubwo byagereranywa n’ububiko bwa hemoglobine n’ububiko bwa fer.
Heinz Zoller, MD, atangaza ko mu bushakashatsi bwa PHOSPHARE-IBD ​​bwakorewe ku barwayi 97 ba IBD bafite ikibazo cyo kubura fer nke giteganijwe kuri carboxymaltose (FCM; Injectafer) na demethylmaltose (FDI; Monoferric).hejuru mu barwayi., Kaminuza y'Ubuvuzi ya Innsbruck, Otirishiya, na bagenzi bawe.
Kuva ku murongo fatizo kugeza ku munsi wa 35, 51% by'abarwayi ba FCM na 8.3% by'abarwayi ba FDI barwaye hypophosphatemia igihe icyo ari cyo cyose, nk'uko bigaragazwa na serumu fosifate iri munsi ya mg / dL (itandukaniro ry'ibyago - 42.8, 95% CI -57.1 kugeza -24.6 )., P <0,0001), - написала группа в Gut. , P <0.0001), itsinda ryanditse muri Gut.
Abashakashatsi bakoresheje ibipimo bimwe bishingiye kuri hemoglobine n'uburemere bw'umubiri ku bicuruzwa byombi kugira ngo birinde ibintu bishobora gutera urujijo mu bigeragezo byabanje. Umubare munini wa hypophosphatemia wabaye mugihe cyibyumweru 2 byambere byatewe, kandi ukomeza kuba mwinshi mumatsinda ya FCM muminsi 70 (59.2% vs 12.5%, P <0.0001). Umubare munini wa hypophosphatemia wabaye mugihe cyibyumweru 2 byambere byatewe, kandi ukomeza kuba mwinshi mumatsinda ya FCM muminsi 70 (59.2% vs 12.5%, P <0.0001). С. Umubare munini wa hypophosphatemia wabaye mugihe cyibyumweru 2 byambere byo kwinjiza kandi ukomeza kuba mwinshi mumatsinda ya FCM nyuma yiminsi 70 (59.2% vs 12.5%, P <0.0001).低磷 血症 的 最高 发生 发生 在 在 的 前 2 周内 ， 并且 在 FCM 组 在 70 天时 仍然 升高 （59.2% vs 12.5% ​​， P <0.0001）。低磷 血症 的 最高 发生 率 发生 在 输注 前 2 周内 ， 并且 在 FCM 组 在 70 天时 仍然 升高 （59.2% vs 12.5% ​​， P <0.000 С. Umubare munini wa hypophosphatemia wabaye mugihe cyibyumweru 2 byambere byo kwinjiza kandi ukomeza kuba hejuru muminsi 70 mumatsinda ya FCM (59.2% vs 12.5%, P <0.0001).
Zoller yatangarije MedPage Today ati: "N'ubwo hari imikorere imwe kandi nta tandukaniro riri hagati y’imyitwarire ya allergique, imyiteguro ibiri ikoreshwa cyane mu bikoresho bya kijyambere bigezweho mu Burayi bifite umutekano ugaragara, kubera ko icyuma cya desmethylmaltose gishobora gufatwa nk'imyiteguro itekanye."
Kubura fer nke ni ikibazo gisanzwe kidasanzwe cya IBD gishobora kubangamira imikorere yumubiri nubwenge kandi bikongera ibyago byo kuba mubitaro.Nkuko byavuzwe haruguru, FCM na FDI byagaragaje imbaraga zingana mugukosora anemia yo kubura fer hamwe no kwiyongera kwa hemoglobine nyuma yiminsi 70 (25.2 na 24.9 g / l).
Itandukaniro mu kwandura hypophosphatemia hagati y’ibiyobyabwenge byombi bisimbuza ibyuma byagaragaye mu bihe byashize byasobanuwe n’uburemere cyangwa etiologiya yo kubura fer, imikorere y’impyiko y’abarwayi, hamwe n’uburyo butandukanye bwo gufata imiti yinjira mu mitsi..Ikigeragezo cyabanje kugereranya uburyo bubiri bwo gusimbuza ibyuma, ikigeragezo cyo muri Amerika PHOSPHARE-IDA, nacyo cyerekanye ko abantu benshi barwara hypophosphatemia muri FCM, nubwo dosiye na gahunda yo kunywa byari bitandukanye ukurikije amakuru yemewe na FDA.
Zoller yagize ati: "Ubushakashatsi buriho bwerekanye kandi ko, nubwo gukira indwara ya hypophosphatemia, inzira ya casade y'impinduka zishingiye ku binyabuzima zijyanye no kwerekana cyane FGF23 [fibroblast growth factor 23], yitwa" 6H syndrome ", itigenga ku barwayi bakira FCM."na bagenzi be baranditse.
Bakomeje bati: "By'umwihariko, amagufwa yihariye [alkaline phosphatase] yagumye hejuru mu itsinda rya FCM ugereranije n'itsinda rya FDI ku munsi wa 70, bivuze ko FCM yagize ingaruka ku ihindurwa ry'amagufwa mu igeragezwa ndetse no hanze yarwo."Ati: "Ubu bushakashatsi bushobora guhuza hypophosphatemia na osteomalacia, ibibazo bigenda byiyongera kuri FCM iherutse gushyirwa ku rutonde nk'umuburo wihariye mu makuru y’i Burayi ku barwayi bafite FCM."
Zoller yatangarije MedPage Today ko ubundi bushakashatsi “bwibanze ku gusobanukirwa impamvu imiti yombi itandukanye mu kwinjiza FGF23, imisemburo itera igisubizo kitoroshye kiganisha kuri hypophosphatemia, kugira ngo hatabaho iterambere ry’ibiyobyabwenge.”Kugira iyi ngaruka no gusobanukirwa n'iri tegeko. ”. ”
PHOSPHARE-IBD ​​ni igeragezwa rihumye kabiri, ryateganijwe ku barwayi 97 ba IBD - 61% barwaye colitis (UC) na 39% bafite indwara ya Crohn (CD) - mu bitaro 20 by’i Burayi kuva 2018. 2020.
Abarwayi bujuje ibisabwa basabye serumu ferritine ya 100 ng / mL cyangwa munsi yayo, urugero rwa hemoglobine ruri munsi ya 130 g / L, kandi bagasaba ko hongerwaho ibyuma byihuse cyangwa bakagira kwihanganira ibyuma byo mu kanwa / kutumva neza, mubindi bipimo.
Abitabiriye amahugurwa batoranijwe ku kigereranyo cya 1: 1 kugirango bakire urugero rumwe rwa FDI cyangwa FCM hashingiwe kuri hemoglobine nuburemere bwumubiri kuri baseline na nyuma yiminsi 35.Ku barwayi bafite gemoglobine iri munsi ya 100 g / l, igipimo cyose ni mg 1500 ku barwayi bapima munsi ya 70 kg na mg 2000 ku barwayi bafite ibiro 70 cyangwa birenga.Abarwayi bafite gemoglobine ya 100 g / l no hejuru bakiriye igipimo cya mg 1500.
Zoller na bagenzi be baranditse bati: “Ukurikije igishushanyo mbonera cy’ubushakashatsi, dushobora kwemeza ko itandukaniro ryagaragaye mu ndwara ya hypophosphatemia riterwa ahanini n’itandukaniro ry’imyiteguro y’icyuma, kandi atari ku gipimo cyuzuye cy’icyuma, uburyo bwo gukoresha, itandukaniro muri CD ugereranije na UC.cyangwa ibindi bintu bifitanye isano n'abarwayi nk'imikorere y'impyiko, ubukana bw'umuriro, urugero rwo kubura fer, cyangwa vitamine D ibura. ”
Ikigereranyo cyo hagati y’abarwayi mu bushakashatsi cyari imyaka 42, 53% ni abagore, abenshi bari abazungu (86%), naho igipimo rusange cy’umubiri cyari 27.6.Ikigereranyo cya hemoglobine kuri baseline cyari 105 g / l.
Inshuro yibintu bibi (AEs) nibintu bikomeye byabaye (AEs) byari bisa nibicuruzwa bitandukanye, ariko ibyinshi byari byoroheje (80-83%).Itsinda rya FCM ryagize vitamine D nyinshi (35% vs 23%) hamwe nindwara nyinshi za nasofaryngitis (20% vs 17%) kuruta itsinda rya FDI.Mu itsinda rya FDI, kubabara umutwe (19% na 10%) byari bisanzwe, kimwe no kugira isesemi (13% na 2%).Abarwayi benshi mu itsinda rya FDI bahagaritse kwivuza kubera AEs (6% vs 2%).
Nubwo ibyo bikorwa byombi byatumye habaho amanota y’umunaniro w’abarwayi, iterambere ryinshi kandi ryihuse ryagaragaye mu itsinda rya FDI, nubwo iri tandukaniro ryatakaje akamaro nyuma yiminsi 70.
Imipaka ntarengwa ikubiyemo igihe gito cyo gukurikirana no kudashobora gusuzuma neza ibyavuye mu mavuriro.
Zaina Hamza ni MedPage Uyu munsi umwanditsi w'abakozi ba gastroenterology n'indwara zanduza.Afite icyicaro i Chicago.
Zoller yatangaje inkunga yatanzwe na Abbvie, Bayer, Falk, Galeedi, Merz, Medice, Pierre Fabre, Pharmacosmos, Sanofi na Vifor.Abanditsi banditse bavuga umubano n’amasosiyete menshi yimiti ninganda.Umwanditsi umwe yavuze kandi ko abanditsi ba patenti bajyanye no gutegura ibyuma byababyeyi.
LINK KU ISOKO: Zoller H n'abandi.“Hypophosphatemia nyuma yo gutanga ibyuma bya desferiomaltose na fer carboxymaltose ku barwayi bafite ikibazo cyo kubura fer kubera indwara yo mu mara (Phosphare-IBD): igeragezwa ry’amavuriro ryateganijwe” Gut 2022;DOI: 10.1136 / gutjnl-2022-327897.
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