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Ngokwesivivinyo saseYurophu esingahleliwe, ukwelashwa kwesimanje okufakwe nge-iron esikhundleni se-iron kubangele izehlakalo eziphezulu kakhulu ze-hypophosphatemia ezigulini ezine-anemia ehambisana nesifo samathumbu esivuvukalayo (IBD), naphezu komphumela ofanayo ku-hemoglobin nezitolo zensimbi.
U-Heinz Zoller, MD, ubika ukuthi ocwaningweni lwe-PHOSPHARE-IBD ​​lweziguli ezingama-97 ze-IBD ezine-anemia yokuntuleka kwe-iron okuhlelelwe i-iron carboxymaltose (FCM; Injectafer) ngokumelene ne-iron demethylmaltose (FDI; Monoferric).aphezulu ezigulini., Medical University of Innsbruck, Austria, kanye nozakwabo.
Kusukela ekuqaleni kuze kufike osukwini lwama-35, u-51% weziguli ze-FCM kanye no-8.3% weziguli ze-FDI zine-hypophosphatemia nganoma yisiphi isikhathi, njengoba kufakazelwa amazinga e-serum phosphate angaphansi kuka-2.0 mg/dL (umehluko wengozi olungisiwe - 42.8, 95% CI -57.1 kuya -24.6 )., P<0,0001), — написала группа в Gut. , P<0.0001), iqembu labhala ku-Gut.
Abacwaningi basebenzise imithamo efanayo esekelwe ku-hemoglobin nesisindo somzimba kuyo yomibili imikhiqizo ukuze kukhishwe izici ezididayo ezingaba khona ezivivinyweni zangaphambilini. Izehlakalo eziphakeme kakhulu ze-hypophosphatemia zenzekile phakathi namaviki angu-2 okuqala okufakwa, futhi zahlala ziphakeme eqenjini le-FCM ezinsukwini ezingu-70 (59.2% vs 12.5%, P<0.0001). Izehlakalo eziphakeme kakhulu ze-hypophosphatemia zenzekile phakathi namaviki angu-2 okuqala okufakwa, futhi zahlala ziphakeme eqenjini le-FCM ezinsukwini ezingu-70 (59.2% vs 12.5%, P<0.0001). Самая высокая частота гипофосфатемии возникла в течение первых 2 недель инфузии и оставалась повышенной в группе FCM через 70 дней (59,2% против 12,5%, P<0,0001). Izehlakalo eziphakeme kakhulu ze-hypophosphatemia zenzekile phakathi namaviki angu-2 okuqala okufakwa futhi zahlala ziphakeme eqenjini le-FCM ngemva kwezinsuku ezingu-70 (59.2% vs 12.5%, P<0.0001).低磷血症的最高发生率发生在输注的前2 周内，并且在FCM 组在70 天时仍然升高（59.20% vs 12.2%,0%低磷血症的最高发生率发生在输注的前2 周内，并且在FCM 组在70 天时仍然升高（59.00% vs 12.2%,0% I-Самая высокая частота гипофосфатемии возникла в течение первых 2 недель инфузии и оставалась повышенной в тегение 10, п5, пение 70, п5, песни 70, пер, 20, пение 70, пе5, песни 70, пер. Izehlakalo eziphakeme kakhulu ze-hypophosphatemia zenzeke phakathi namaviki angu-2 okuqala okufakwa futhi zahlala ziphakeme izinsuku ezingu-70 eqenjini le-FCM (59.2% vs 12.5%, P<0.0001).
"Naphezu kokusebenza okufanayo futhi akukho mehluko ekuphenduleni kwe-allergies, amalungiselelo ensimbi amabili asetshenziswa kakhulu esimanje asetshenziswa kakhulu e-Europe anephrofayili ecacile yokuphepha, njengoba insimbi ye-desmethylmaltose ingabhekwa njengelungiselelo eliphephile," kusho u-Zoller etshela i-MedPage Today.
I-anemia yokuntuleka kwe-iron iyinkimbinkimbi evamile yangaphandle kwamathumbu e-IBD engakhinyabeza ukusebenza ngokomzimba nangokomqondo futhi yandise ingozi yokulaliswa esibhedlela.Njengoba kushiwo ngaphambili, i-FCM ne-FDI ibonise ukusebenza kahle okuqhathaniswayo ekulungiseni i-anemia yokuntuleka kwensimbi cishe ngokunyuka okufanayo kwe-hemoglobin ngemva kwezinsuku ezingu-70 (25.2 kanye no-24.9 g/l, ngokulandelana).
Umehluko ezehlakalweni ze-hypophosphatemia phakathi kwezidakamizwa ezimbili ezithatha indawo yensimbi ezabonwa esikhathini esidlule wachazwa ngokwengxenye ubukhulu noma i-etiology yokuntuleka kwe-iron, ukusebenza okucashile kwezinso kweziguli, kanye nemithi ehlukene yomthamo wemithi efakwa emthanjeni..Uhlolo lwangaphambilini olungahleliwe oluqhathanisa izindlela zokwelapha ezimbili zokubuyisela insimbi, uhlolo lwase-US PHOSPHARE-IDA, luphinde lwabonisa izehlakalo eziphezulu ze-hypophosphatemia ku-FCM, nakuba umthamo namashejuli womthamo ahluka ngokuya ngolwazi olufanele olugunyazwe yi-FDA.
"Ucwaningo lwamanje luphinde lwabonisa ukuthi, naphezu kokululama ku-hypophosphatemia, inkambo ye-cascade yezinguquko ze-biochemical ezihambisana nokuvezwa okuphezulu kwe-FGF23 [i-fibroblast growth factor 23], ebizwa ngokuthi "i-6H syndrome", izimele ezigulini ezithola i-FCM," i-Zoller.nozakwabo babhala.
"Ikakhulukazi, i-bone-specific [alkaline phosphatase] yahlala iphakeme eqenjini le-FCM uma kuqhathaniswa neqembu le-FDI ngosuku lwama-70, okusho ukuthi i-FCM ithinte ukuguqulwa kwamathambo kulo lonke lolu cwaningo nangale kwalokho," baqhubeka."Lokhu okutholakele kungase kuxhumanise i-hypophosphatemia ne-osteomalacia, inkinga ekhulayo ye-FCM esanda kufakwa ohlwini njengesixwayiso esikhethekile olwazini lwase-Europe lweziguli ezine-FCM."
UZoller utshele i-MedPage Namuhla ukuthi ucwaningo olwengeziwe "lugxile ekuqondeni ukuthi kungani le mithi yomibili ihluke ekufakweni kwayo kwe-FGF23, i-hormone ebangela impendulo eyinkimbinkimbi eholela ku-hypophosphatemia, ukugwema ukukhula kwezidakamizwa esikhathini esizayo."Ukuze ube nalo mphumela ohlangothini futhi uqonde lokhu kungasebenzi kahle. ”.”
I-PHOSPHARE-IBD ​​​​isivivinyo esingaboni kabili, esingahleliwe seziguli ezingama-97 ze-IBD - ama-61% ane-ulcerative colitis (UC) kanye nama-39% anesifo sikaCrohn (CD) - ezibhedlela ezingama-20 zaseYurophu kusukela ngo-2018.
Iziguli ezifanelekile zazidinga izinga le-serum ferritin elingu-100 ng/mL noma eliphansi, izinga le-hemoglobin elingaphansi kuka-130 g/L, futhi lalidinga ukwengezwa kwensimbi ngokushesha noma libe nokungabekezelelani kwensimbi yomlomo/ukungezwani, phakathi kwezinye izindlela.
Ababambiqhaza bahlelwe ngokungahleliwe ngesilinganiso esingu-1:1 ukuze bathole umthamo ofanayo we-FDI noma i-FCM ngokusekelwe ku-hemoglobin nesisindo somzimba ekuqaleni kanye nezinsuku ezingu-35 kamuva.Ezigulini ezinamazinga e-hemoglobin angaphansi kwe-100 g / l, umthamo ophelele ngu-1500 mg ezigulini ezinesisindo esingaphansi kwama-70 kg no-2000 mg ezigulini ezinesisindo esingama-70 kg noma ngaphezulu.Iziguli ezinezinga le-hemoglobin lika-100 g/l nangaphezulu zithole isilinganiso esiphelele esingu-1500 mg.
UZoller nozakwabo babhala: “Uma kucatshangelwa ukuklanywa kocwaningo, kungafinyelelwa esiphethweni sokuthi umehluko ophawuliwe ezenzakalweni ze-hypophosphatemia ubangelwa ngokuphelele umehluko wamalungiselelo ensimbi, hhayi kumthamo ophelele wensimbi, uhlobo lomthamo, umehluko ku-CD. kuqhathaniswa ne-UC.noma ezinye izici ezihlobene nesiguli ezifana nokusebenza kwezinso, ukuqina kokuvuvukala, izinga lokuntuleka kwensimbi, noma ukuntula uvithamini D.”
Iminyaka emaphakathi yeziguli ocwaningweni yayiyiminyaka engama-42, ama-53% kwakungabesifazane, iningi limhlophe (86%), kanti inkomba yesisindo somzimba i-27.6.Izinga elijwayelekile le-hemoglobin ekuqaleni laliyi-105 g/l.
Imvamisa yezehlakalo ezimbi (ama-AE) kanye nezehlakalo ezimbi kakhulu (AEs) zazifana emikhiqizweni ehlukene, kodwa iningi lazo lalimnene (80-83%).Iqembu le-FCM libe nokushoda kwe-vitamin D okwengeziwe (35% vs 23%) kanye nezimo eziningi ze-nasopharyngitis (20% vs 17%) kuneqembu le-FDI.Eqenjini le-FDI, ikhanda (19% vs. 10%) lalivame kakhulu, njengoba kwakunjalo isicanucanu (13% vs. 2%).Iziguli ezengeziwe eqenjini le-FDI ziye zayeka ukwelashwa ngenxa yama-AEs (6% vs 2%).
Nakuba kokubili ukungenelela kuholele ekuthuthukisweni kwamaphuzu okukhathala abikwe ngesiguli, ukuthuthukiswa okukhulu nokusheshayo kwabonakala eqenjini le-FDI, nakuba lo mehluko ulahlekelwe ukubaluleka ngemva kwezinsuku ezingu-70.
Imikhawulo yedatha ihlanganisa isikhathi esifushane sokulandelela kanye nokungakwazi ukuhlola ngokugcwele imiphumela yomtholampilo.
U-Zaina Hamza ungumbhali we-MedPage wanamuhla we-gastroenterology kanye nezifo ezithathelwanayo.Uzinze eChicago.
UZoller umemezele uxhaso oluvela kwa-Abbvie, Bayer, Falk, Gilead, Merz, Medice, Pierre Fabre, Pharmacosmos, Sanofi kanye neVifor.Ababhali ababambisene babika ubudlelwano nezinkampani eziningana zemithi nezimboni.Umbhali ohlangene uphinde wabika ababhali ababambisene bamalungelo obunikazi ahlobene namalungiselelo ensimbi yomzali.
ISIXHUMANISO SOMthombo: U-Zoller H et al."I-Hypophosphatemia ngemva kokuphathwa kwe-iron desferiomaltose ne-iron carboxymaltose ezigulini ezine-anemia yokuntuleka kwensimbi ngenxa yesifo sofuba esivuthayo (i-Phosphare-IBD): isilingo somtholampilo esingahleliwe" Gut 2022;I-DOI: 10.1136/gutjnl-2022-327897.
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