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病灶内注射溶组织梭状芽孢杆菌胶原酶(CCH)治疗成人佩罗尼氏病(PD)的临床安全性分析。

Analysis of the clinical safety of intralesional injection of collagenase Clostridium histolyticum (CCH) for adults with Peyronie's disease (PD).

作者信息

Carson Culley C, Sadeghi-Nejad Hossein, Tursi James P, Smith Ted M, Kaufman Gregory J, Gilbert Kimberly, Honig Stanton C

机构信息

Department of Surgery, University of North Carolina, Chapel Hill, NC, USA.

Rutgers New Jersey Medical School and Hackensack University Medical Center, Hackensack, NJ, USA.

出版信息

BJU Int. 2015 Nov;116(5):815-22. doi: 10.1111/bju.13120. Epub 2015 May 13.

Abstract

OBJECTIVE

To examine the safety of intralesional injection of collagenase Clostridium histolyticum (CCH) for the treatment of Peyronie's disease (PD), using a pooled safety analysis of patients who received at least one dose of CCH in any of six clinical studies.

PATIENTS AND METHODS

Patients from six clinical studies, including three randomised, double-blind, placebo-controlled studies and three open-label safety and efficacy studies, were included if they had received at least one dose of 0.58 mg CCH. Adverse events (AEs), including treatment-emergent AEs, treatment-related AEs, and serious AEs (SAEs), were characterised. Potential immunogenicity-related AEs were evaluated through examination of increased anti-AUX-I and anti-AUX-II antibody levels, AEs, and reported terms possibly associated with immunological or hypersensitivity events.

RESULTS

Overall, 85.8% of 1 044 pooled patients reported at least one treatment-related AE. The most frequently reported (≥25.0% of patients) treatment-related AEs included penile haematoma (82.7% had the verbatim 'penile bruising'), penile pain, and penile swelling. Most patients (75.2%) had mild- or moderate-severity treatment-related AEs, and 14.2% had no treatment-related AEs. Nine patients (0.9%) had treatment-related SAEs: five with penile haematoma and four with corporal rupture. There was no association between AEs and anti-AUX-I or anti-AUX-II antibody levels across treatment cycles, and no systemic hypersensitivity reactions occurred.

CONCLUSIONS

This pooled safety analysis shows that although non-serious and serious treatment-related AEs can occur after CCH treatment for PD, most were non-serious and the SAEs were manageable. Providers should be prepared to manage possible SAEs.

摘要

目的

通过对六项临床研究中任何一项接受过至少一剂溶组织梭状芽孢杆菌胶原酶(CCH)的患者进行汇总安全性分析,探讨病灶内注射CCH治疗佩罗尼氏病(PD)的安全性。

患者与方法

纳入六项临床研究中的患者,其中包括三项随机、双盲、安慰剂对照研究以及三项开放标签安全性和有效性研究,这些患者均接受过至少一剂0.58 mg的CCH。对不良事件(AE)进行了特征描述,包括治疗中出现的AE、与治疗相关的AE以及严重AE(SAE)。通过检测抗AUX-I和抗AUX-II抗体水平升高、AE以及报告的可能与免疫或超敏反应事件相关的术语,评估潜在的免疫原性相关AE。

结果

总体而言,1044例汇总患者中有85.8%报告了至少一项与治疗相关的AE。报告频率最高(≥25.0%的患者)的与治疗相关的AE包括阴茎血肿(82.7%的患者有“阴茎瘀伤”的确切表述)、阴茎疼痛和阴茎肿胀。大多数患者(75.2%)出现轻度或中度严重程度的与治疗相关的AE,14.2%的患者未出现与治疗相关的AE。九名患者(0.

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