Puthenparumpil J J, Keough-Ryan T, Kiberd M, Lawen J, Kiberd B A
Department of Urology, Queen Elizabeth II Health Sciences Center, Halifax, Nova Scotia, Canada.
Transplant Proc. 2005 Mar;37(2):1033-5. doi: 10.1016/j.transproceed.2004.12.231.
Given the high incidence of lipid abnormalities, high burden of cardiovascular disease, and high proportion who do not achieve target levels despite therapy in the kidney transplant population, additional lipid lowering strategies are needed.
This was a nonrandomized, open-label, single-cohort evaluation of ezetimibe, a novel cholesterol absorption inhibitor, in 40 stable kidney transplant recipients with hypercholesterolemia.
After 4 weeks of therapy total and LDL cholesterol were reduced by 23 +/- 13% (P < .0001) and 33 +/- 15% (P < .0001), respectively. The drug was equally effective in patients on cyclosporine (19), tacrolimus (13), or sirolimus (8), but more effective (P = .0006) when used in combination with a statin (41 +/- 13% reduction in LDL, n = 22) compared with monotherapy (24% +/- 13%, n = 18). There were no significant effects on serum creatinine, drug levels, body weight, or liver function tests.
Ezetimibe is an effective LDL cholesterol-lowering agent in the kidney transplant population. Further studies are warranted in a larger population not only to examine the extent of cardiovascular risk reduction but also to detect unwarranted toxicity.
鉴于肾移植人群中脂质异常的高发生率、心血管疾病的高负担以及尽管接受治疗仍有高比例患者未达到目标水平，需要额外的降脂策略。
这是一项对40例患有高胆固醇血症的稳定肾移植受者进行的非随机、开放标签、单队列依泽替米贝（一种新型胆固醇吸收抑制剂）评估。
治疗4周后，总胆固醇和低密度脂蛋白胆固醇分别降低了23±13%（P<.0001）和33±15%（P<.0001）。该药物在使用环孢素（19例）、他克莫司（13例）或西罗莫司（8例）的患者中同样有效，但与单药治疗（24%±13%，n = 18）相比，与他汀类药物联合使用时更有效（低密度脂蛋白降低41±13%，n = 22）（P =.0006）。对血清肌酐、药物水平、体重或肝功能检查无显著影响。
依泽替米贝是肾移植人群中一种有效的降低低密度脂蛋白胆固醇的药物。有必要在更大规模人群中进行进一步研究，不仅要检查心血管风险降低的程度，还要检测不必要的毒性。
