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日本进行的非盲法临床研究:苯扎贝特治疗脂肪酸氧化障碍患者;第2份报告——生活质量调查

Open-label clinical trial of bezafibrate treatment in patients with fatty acid oxidation disorders in Japan; 2nd report QOL survey.

作者信息

Shiraishi Hideaki, Yamada Kenji, Oki Eishin, Ishige Mika, Fukao Toshiyuki, Hamada Yusuke, Sakai Norio, Ochi Fumihiro, Watanabe Asami, Kawakami Sanae, Kuzume Kazuyo, Watanabe Kenji, Sameshima Koji, Nakamagoe Kiyotaka, Tamaoka Akira, Asahina Naoko, Yokoshiki Saki, Miyakoshi Takashi, Oba Koji, Isoe Toshiyuki, Hayashi Hiroshi, Yamaguchi Seiji, Sato Norihiro

机构信息

Department of Pediatrics, Hokkaido University School of Medicine, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan.

Department of Pediatrics, Shimane University Faculty of Medicine, 89-1, En-ya-cho, Izumo, Shimane 693-8501, Japan.

出版信息

Mol Genet Metab Rep. 2019 Jul 25;20:100496. doi: 10.1016/j.ymgmr.2019.100496. eCollection 2019 Sep.

Abstract

INTRODUCTION

Fatty acid oxidation disorders (FAODs) are rare diseases caused by a defective mitochondrial fatty acid oxidation (FAO) enzyme. We recently reported that bezafibrate improved patient quality of life (QOL) based on the SF-36 questionnaire score in patients with FAODs during a 50-week, open-label, clinical trial. Herein we conducted further survey assessments of the trial patients to define the long-term efficacy and safety of bezafibrate.

MATERIALS AND METHODS

This trial was an open-label, non-randomized, and multicenter study of bezafibrate treatment in five patients with very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency and one patient with carnitine palmitoyltransferase-II (CPT-2) deficiency (median age, 15.9 years; range, 5.8-26.4 years). The bezafibrate administration was continued for a further 102-174 weeks after the 24-week treatment described in our previous study. QOL was quantitated using the 36-Item Short Form Health Survey (SF-36) questionnaire, which constitutes eight components: physical functioning (PF), role limitation due to physical problems, bodily pain, general health perception, vitality, social functioning, role limitation due to emotional problems, and mental health.

RESULTS

PF was elevated in all patients and continued to rise during the study, with the total QOL scores increased from baseline in five of the six cases. In particular, three patients older than 20 years showed treatment efficacy, and all subcategories of QOL were elevated in two of these cases.

CONCLUSION

Our findings supported one of the stated benefits of bezafibrate in improving QOL for patients with FAODs.

摘要

引言

脂肪酸氧化障碍(FAODs)是由线粒体脂肪酸氧化(FAO)酶缺陷引起的罕见疾病。我们最近报告称,在一项为期50周的开放标签临床试验中,基于SF - 36问卷评分,苯扎贝特改善了FAODs患者的生活质量(QOL)。在此,我们对试验患者进行了进一步的调查评估,以确定苯扎贝特的长期疗效和安全性。

材料与方法

本试验是一项开放标签、非随机、多中心的研究,对5例极长链酰基辅酶A脱氢酶(VLCAD)缺乏症患者和1例肉碱棕榈酰转移酶II(CPT - 2)缺乏症患者(中位年龄15.9岁;范围5.8 - 26.4岁)进行苯扎贝特治疗。在我们之前研究中描述的24周治疗后,苯扎贝特给药又持续了102 - 174周。使用36项简短健康调查(SF - 36)问卷对生活质量进行量化,该问卷由八个部分组成:身体功能(PF)、因身体问题导致的角色限制、身体疼痛、总体健康感知、活力、社会功能、因情绪问题导致的角色限制和心理健康。

结果

所有患者的身体功能均有所提高,且在研究期间持续上升,6例患者中有5例的总体生活质量评分较基线有所增加。特别是,3例年龄超过20岁的患者显示出治疗效果,其中2例患者生活质量的所有子类别均有所提高。

结论

我们的研究结果支持了苯扎贝特在改善FAODs患者生活质量方面所述益处之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfbe/6661278/e43749278127/gr1.jpg

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