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抑制指数的临床应用:在HIV蛋白酶抑制剂治疗中是否有作用?

Clinical application of the inhibitory quotient: is there a role in HIV protease inhibitor therapy?

作者信息

Winston Alan, Khoo Saye

机构信息

Section of Infectious Diseases, Division of Medicine, Imperial College, London W2 1NY, UK.

出版信息

Curr Opin HIV AIDS. 2008 Nov;3(6):608-11. doi: 10.1097/COH.0b013e328312972e.

Abstract

PURPOSE OF REVIEW

The inhibitory quotient of boosted protease inhibitors is a measurement incorporating both plasma drug exposure and resistance testing. Inhibitory quotients have been assessed in over 50 clinical studies to date, many of these studies describe highly significant associations between the inhibitory quotient and virological outcomes. This review will focus on studies that assess the inhibitory quotient in a prospective fashion and with the use of newly available boosted protease inhibitors.

RECENT FINDINGS

Atazanavir, darunavir and tipranavir are the three most recently licensed protease inhibitors. Studies have described associations between the inhibitory quotient and outcomes for all of these agents with cutoff inhibitory quotient values now proposed for all of these protease inhibitors.A prospective study has assessed the use of inhibitory quotient across many different protease inhibitor regimens and although no overall benefit was described, improved clinical outcomes were observed in specific patient groups.

SUMMARY

Although ongoing challenges need to be overcome, recent studies have described associations between this useful parameter and modern day antiretroviral regimens.

摘要

综述目的

增强型蛋白酶抑制剂的抑制商数是一种综合血浆药物暴露和耐药性检测的测量方法。迄今为止,已有50多项临床研究对抑制商数进行了评估,其中许多研究描述了抑制商数与病毒学结果之间高度显著的关联。本综述将聚焦于以前瞻性方式评估抑制商数并使用新上市增强型蛋白酶抑制剂的研究。

最新发现

阿扎那韦、达芦那韦和替拉那韦是最近获批的三种蛋白酶抑制剂。研究描述了所有这些药物的抑制商数与结果之间的关联,目前已针对所有这些蛋白酶抑制剂提出了抑制商数临界值。一项前瞻性研究评估了抑制商数在多种不同蛋白酶抑制剂治疗方案中的应用,尽管未描述出总体益处,但在特定患者群体中观察到了改善的临床结果。

总结

尽管仍需克服持续存在的挑战,但最近的研究已描述了这一有用参数与现代抗逆转录病毒治疗方案之间的关联。

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