Mateo-Carrasco Hector, Kostrzynski Oluwakemi, Ndefo Onyinye, Stapley Simon, Davies Elaine, Agarwal Roshan
Aseptic Services Unit, Pharmacy Department, Northampton General Hospital NHS Trust, Cliftonville, Northampton, NN1 5BD, UK.
Northampton Centre for Oncology, Northampton General Hospital NHS Trust, Northampton, UK.
Int J Clin Pharm. 2017 Aug;39(4):657-661. doi: 10.1007/s11096-016-0416-0. Epub 2017 Apr 25.
Background Hypomagnesaemia is a relatively-common side effect of some systemic anti-cancer therapies (SACT). Oral and intravenous magnesium (given as injections or short infusions) have problems arising from their poor tolerability, and need for frequent administrations, respectively. Objective Assessing the effectiveness and safety of weekly continuous magnesium infusions (CMI) in the management of SACT-related hypomagnesaemia. Methods CMIs (initiated at 10 mmol/day and up-titrated subject to response) were prescribed to patients with ≥3 magnesium readings <0.5 mmol/L despite intravenous replacement with bolus-or-short-infusions (BSI). Efficacy (compared to BSI): (a) reduction in the number of moderate/severe hypomagnesaemia episodes, and (b) increase in mean magnesium serum levels.
non-occurrence of grade ≥3 toxicities (according to the common terminology criteria for adverse events v4). Results Three patients were treated (mean age: 62-years), pre-SACT levels were 0.629 ± 0.121 mmol/L.
(a) 1 versus 18 episodes; (b) 0.639 ± 0.093 mmol/L versus 0.533 ± 0.191 mmol/L. All comparisons were statistically significant in favour of CMI (p < 0.001). No magnesium-related grade ≥2 side effects were observed. Conclusion CMIs resulted in a marked reduction in the number of episodes of hypomagnesaemia and higher magnesium levels, with no significant side effects. CMIs represent a potential option for the management of SACT-related hypomagnesaemia, although further research in an expanded cohort is required.
背景 低镁血症是某些全身抗癌治疗（SACT）相对常见的副作用。口服和静脉注射镁（以注射或短时间输注形式给药）分别存在耐受性差和需要频繁给药的问题。目的 评估每周持续镁输注（CMI）治疗SACT相关低镁血症的有效性和安全性。方法 尽管采用大剂量或短时间静脉输注（BSI）进行了镁补充，但对于≥3次镁读数<0.5 mmol/L的患者，给予CMI（起始剂量为10 mmol/天，并根据反应进行滴定）。疗效（与BSI相比）：（a）中重度低镁血症发作次数减少，（b）血清镁平均水平升高。
未发生≥3级毒性反应（根据不良事件通用术语标准第4版）。结果 治疗了3例患者（平均年龄：62岁），SACT治疗前镁水平为0.629±0.121 mmol/L。
（a）1次发作与18次发作；（b）0.639±0.093 mmol/L与0.533±0.191 mmol/L。所有比较均具有统计学意义，支持CMI（p<0.001）。未观察到与镁相关的≥2级副作用。结论 CMI导致低镁血症发作次数显著减少且镁水平升高，无明显副作用。CMI是治疗SACT相关低镁血症的一种潜在选择，尽管需要在更大队列中进行进一步研究。
