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依伐卡托特治疗 6 岁以下儿童囊性纤维化。

Ivacaftor for the treatment of cystic fibrosis in children under six years of age.

机构信息

Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

出版信息

Expert Rev Respir Med. 2020 Jun;14(6):547-557. doi: 10.1080/17476348.2020.1741352. Epub 2020 Mar 17.

Abstract

Cystic fibrosis (CF) results from aberrant ion transport due to abnormalities or absence of the cystic fibrosis transmembrane conductance regulator (CFTR), a chloride transporter that resides on the apical surface of epithelial cells. A novel class of medications, known as CFTR modulators, specifically target the abnormal protein.: Ivacaftor increases the open probability of CFTR located on the cell surface, leading to enhanced chloride transport, and has been shown to improve lung function, weight, and quality of life. We reviewed the sentinel studies that lead to the approval of the use of ivacaftor in people with CF age six months and older with at least one CFTR gene mutation that is responsive to ivacaftor based on clinical trial and/or data. Children with CF have the greatest potential to benefit from CFTR modulator therapy when it is initiated prior to the development of permanent damage; however, challenges remain regarding use of ivacaftor in the youngest pediatric population.: Ivacaftor is safe and effective CFTR modulator that can be prescribed in children over six months of age with at least one CFTR gene mutation that is responsive to ivacaftor.

摘要

囊性纤维化 (CF) 是由于囊性纤维化跨膜电导调节因子 (CFTR) 的异常或缺失导致的离子转运异常引起的,CFTR 是一种位于上皮细胞顶膜表面的氯离子转运体。一类新型药物,称为 CFTR 调节剂,专门针对异常蛋白。依伐卡托增加位于细胞表面的 CFTR 的开放概率,导致氯离子转运增强,并已被证明可改善肺功能、体重和生活质量。我们回顾了导致依伐卡托在至少有一个对依伐卡托有反应的 CFTR 基因突变的年龄在六个月及以上的 CF 患者中使用的主要研究,这些研究是基于临床试验和/或数据得出的。当 CFTR 调节剂治疗在永久性损伤发生之前开始时,患有 CF 的儿童受益最大;然而,在最小的儿科人群中使用依伐卡托仍然存在挑战。依伐卡托是一种安全有效的 CFTR 调节剂,可用于至少有一个对依伐卡托有反应的 CFTR 基因突变的六个月以上的儿童。

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