Stefoni Sergio, Cianciolo Giuseppe, Baraldi Olga, Iorio Mario, Angelini Maria Laura
S.Orsola University Hospital, Department of Experimental, Diagnostic and Speciality Medicine, Dialysis, Nephrology and Trasplantation Unit , Via Massarenti, 9, Bologna, 40138 , Italy
Expert Opin Emerg Drugs. 2014 Jun;19(2):183-99. doi: 10.1517/14728214.2014.900044. Epub 2014 May 16.
Chronic kidney disease (CKD) is a worldwide health problem. Despite remarkable headway in slowing the progression of kidney diseases, the incidence of end-stage renal disease (ESRD) is increasing in all countries with a severe impact on patients and society. The high incidence of diabetes and hypertension, along with the aging population, may partially explain this growth. Currently, the mainstay of pharmacological treatment for CKD, aiming to slow progression to ESRD are ACE inhibitors and angiotensin II receptor blockers for their hemodynamic/antihypertensive and anti-inflammatory/antifibrotic action. However, novel drugs would be highly desirable to effectively slow the progressive renal function loss.
Through the search engines, PubMed and ClinicalTrial.gov, the scientific literature was reviewed in search of emerging drugs in Phase II or III trials, which appear to be the most promising for CKD treatment.
The great expectations for new drugs for the management of CKD over the last decade have unfortunately not been met. Encouraging results from preliminary studies with specific agents need to be tempered with caution, given the absence of consistent and adequate data. To date, several agents that showed great promise in animal studies have been less effective in humans.
慢性肾脏病(CKD)是一个全球性的健康问题。尽管在减缓肾脏疾病进展方面取得了显著进展,但终末期肾病(ESRD)的发病率在所有国家都在上升,对患者和社会造成了严重影响。糖尿病和高血压的高发病率以及人口老龄化可能部分解释了这种增长。目前,旨在减缓向ESRD进展的CKD药物治疗的主要手段是ACE抑制剂和血管紧张素II受体阻滞剂,因其具有血流动力学/抗高血压和抗炎/抗纤维化作用。然而,非常需要新型药物来有效减缓肾功能的渐进性丧失。
通过搜索引擎PubMed和ClinicalTrial.gov,对科学文献进行了综述,以寻找处于II期或III期试验的新兴药物,这些药物似乎对CKD治疗最有前景。
遗憾的是,过去十年中对用于管理CKD的新药的巨大期望并未实现。鉴于缺乏一致和充分的数据,对特定药物的初步研究得出的令人鼓舞的结果需要谨慎对待。迄今为止,几种在动物研究中显示出巨大前景的药物在人类中的效果较差。