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一项关于贝前列素钠治疗猫慢性肾病的双盲、安慰剂对照、多中心、前瞻性、随机研究。

A Double-blind, Placebo-controlled, Multicenter, Prospective, Randomized Study of Beraprost Sodium Treatment for Cats with Chronic Kidney Disease.

作者信息

Takenaka M, Iio A, Sato R, Sakamoto T, Kurumatani H

机构信息

Animal Clinical Research Foundation, Kurayoshi, Tottori, Japan.

Toray Industries, Inc., Tokyo, Japan.

出版信息

J Vet Intern Med. 2018 Jan;32(1):236-248. doi: 10.1111/jvim.14839. Epub 2017 Nov 13.

Abstract

BACKGROUND

Chronic kidney disease (CKD) is a common progressive and irreversible disease in cats. The efficacy and safety of beraprost sodium (BPS) in cats with CKD have not been evaluated.

HYPOTHESIS/OBJECTIVES: To evaluate the efficacy and safety of BPS in the treatment of cats with CKD, as compared to placebo.

ANIMALS

Seventy-four client-owned cats with naturally occurring CKD.

METHODS

Double-blind, placebo-controlled, multicenter, prospective, randomized trial. The cats received BPS (55 μg/cat) or a placebo PO q12 h for 180 days. The primary endpoint was prospectively defined as a change in the serum creatinine (sCr), serum phosphorus-to-calcium ratio or urine specific gravity (USG).

RESULTS

The sCr increased significantly (P = 0.0030) in the placebo group (mean ± SD: 2.8 ± 0.7 to 3.2 ± 1.3 mg/dL) but not in the BPS group (2.4 ± 0.7 to 2.5 ± 0.7 mg/dL). The difference between the groups at day 180 was significant (0.8 mg/dL, 95% CI: 0.2 to 1.3 mg/dL, P = 0.0071). The serum phosphorus-to-calcium ratio was significantly (P = 0.0037) increased in the placebo group (0.46 ± 0.10 to 0.52 ± 0.21 mg/dL) but not in the BPS group (0.50 ± 0.08 to 0.51 ± 0.11 mg/dL). There was no significant change in the USG in either group. An adverse event judged as being treatment-related included vomiting that occurred in 1 case in the placebo group. No clinically relevant change was observed in the CBC and other blood chemistry tests.

CONCLUSIONS AND CLINICAL IMPORTANCE

Beraprost sodium treatment was well tolerated and safe in cats with CKD. BPS inhibited the reduction in renal filtration function as measured by sCr increase.

摘要

背景

慢性肾脏病(CKD)是猫常见的一种进行性、不可逆疾病。贝前列素钠(BPS)在患有CKD的猫中的疗效和安全性尚未得到评估。

假设/目的:与安慰剂相比,评估BPS治疗患有CKD的猫的疗效和安全性。

动物

74只客户拥有的自然发生CKD的猫。

方法

双盲、安慰剂对照、多中心、前瞻性、随机试验。猫接受BPS(55μg/猫)或安慰剂口服,每12小时一次,共180天。主要终点前瞻性定义为血清肌酐(sCr)、血清磷钙比或尿比重(USG)的变化。

结果

安慰剂组sCr显著升高(P = 0.0030)(均值±标准差:从2.8±0.7至3.2±1.3mg/dL),而BPS组未升高(从2.4±0.7至2.5±0.7mg/dL)。180天时两组间差异显著(0.8mg/dL,95%可信区间:0.2至1.3mg/dL,P = 0.0071)。安慰剂组血清磷钙比显著升高(P = 0.0037)(从0.46±0.10至0.52±0.21mg/dL),而BPS组未升高(从0.50±0.08至0.51±0.11mg/dL)。两组USG均无显著变化。判定为与治疗相关的不良事件包括安慰剂组1例出现呕吐。在全血细胞计数和其他血液化学检查中未观察到临床相关变化。

结论及临床意义

贝前列素钠治疗对患有CKD的猫耐受性良好且安全。BPS抑制了以sCr升高衡量的肾滤过功能降低。

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