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伊米苷酶治疗戈谢病的长期国际安全性经验。

The long-term international safety experience of imiglucerase therapy for Gaucher disease.

作者信息

Starzyk Kathryn, Richards Susan, Yee John, Smith Sharon E, Kingma Wytske

机构信息

Genzyme Corporation, Cambridge, MA, USA.

出版信息

Mol Genet Metab. 2007 Feb;90(2):157-63. doi: 10.1016/j.ymgme.2006.09.003. Epub 2006 Oct 31.

Abstract

BACKGROUND

Gaucher disease is a lysosomal storage disorder resulting from a deficiency of the lysosomal enzyme glucocerebrosidase. Since approval by the FDA in 1994 and EMEA in 1997, enzyme replacement therapy with Cerezyme (imiglucerase for injection) has been the standard of care for the treatment of Gaucher disease.

OBJECTIVE

To review the long-term international safety experience of imiglucerase from 1994 through 2004.

MATERIALS AND METHODS

All spontaneous adverse event reports captured in the pharmacovigilance database for imiglucerase from 1994 through 2004 were analyzed. All adverse events were classified using the current version of the Medical Dictionary for Regulatory Activities (MedDRA). Patients without prior exposure to imiglucerase from 1994 through 2005 were assessed for the development of antibodies to imiglucerase as detected by enzyme-linked immunosorbant and radioimmunoprecipitation assays.

RESULTS

Analysis of the long-term safety experience with imiglucerase therapy demonstrates a stable and low rate of adverse events and seroconversion from 1994 through 2005. The majority of frequently reported adverse events related to imiglucerase were infusion-associated reactions which were predominantly self-limiting in nature and did not require discontinuation of treatment. Between 1994 and 2005, IgG antibodies to imiglucerase were detected in approximately 15% of treatment-naïve patients.

CONCLUSIONS

The long-term stability of reported events and seroconversion is a reflection of a well-characterized cell expression system and a mature quality-controlled manufacturing process. Imiglucerase is a safe therapy for the treatment of Gaucher disease with a stable and low rate of reported adverse events and seroconversion.

摘要

背景

戈谢病是一种溶酶体贮积症,由溶酶体酶葡萄糖脑苷脂酶缺乏所致。自1994年获美国食品药品监督管理局(FDA)批准及1997年获欧洲药品管理局(EMEA)批准以来,用思而赞(注射用伊米苷酶)进行酶替代疗法一直是治疗戈谢病的标准治疗方法。

目的

回顾1994年至2004年伊米苷酶的长期国际安全性经验。

材料与方法

分析1994年至2004年伊米苷酶药物警戒数据库中收集的所有自发不良事件报告。所有不良事件均使用当前版本的《监管活动医学词典》(MedDRA)进行分类。对1994年至2005年未预先接触过伊米苷酶的患者进行评估,通过酶联免疫吸附测定和放射免疫沉淀测定检测其是否产生伊米苷酶抗体。

结果

对伊米苷酶治疗的长期安全性经验分析表明,1994年至2005年不良事件和血清转化发生率稳定且较低。与伊米苷酶相关的最常报告的不良事件大多为输液相关反应,本质上主要为自限性,无需停药。1994年至2005年,在约15%的未接受过治疗的患者中检测到伊米苷酶IgG抗体。

结论

报告事件和血清转化的长期稳定性反映了一个特征明确的细胞表达系统和成熟的质量控制生产工艺。伊米苷酶是治疗戈谢病的一种安全疗法,报告的不良事件和血清转化发生率稳定且较低。

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