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胱氨酸病患者接受 0.55%盐酸半胱氨酸治疗的长期随访。

Long-term follow-up of cystinosis patients treated with 0.55% cysteamine hydrochloride.

机构信息

Sorbonne Universités, INSERM, CNRS, Institut de la Vision, Paris, France

Sorbonne Universités, INSERM, CNRS, Institut de la Vision, Paris, France.

出版信息

Br J Ophthalmol. 2021 May;105(5):608-613. doi: 10.1136/bjophthalmol-2020-316450. Epub 2020 Jun 27.

Abstract

BACKGROUND/AIMS: Cystinosis is a rare, autosomal recessive disorder causing defective transport of cystine out of lysosomes. Cystadrops (0.55% cysteamine hydrochloride in viscous solution) has been used on a named-patient basis to treat the accumulation of cystine crystals in the cornea in patients with cystinosis.

METHODS

Retrospective analysis of the Temporary Authorisation for Use cohort of 130 patients who received Cystadrops between 2013 and 2017 in France.

RESULTS

Patients received an average dosage of 3.3 (±0.94) instillations per eye per day. Over the duration of follow-up, of up to 45 months, patients maintained visual acuity scores of 0.0, which approximated normal. Corneal cystine crystal scores tended to decrease over time, stabilising after around 27 months between 1.22 and 1.87. Photophobia decreased within 3 months, stabilising on scores of around 1.5 and 1.7. 47 non-serious adverse reactions were reported, which were generally transient irritation, stinging or blurred vision. Four serious adverse events were reported, including keratitis and corneal ulcer, but these may have been caused by the underlying disease.

CONCLUSION

This large safety cohort confirms the efficacy, safety and tolerability of Cystadrops in real-world clinical practice.

摘要

背景/目的:胱氨酸贮积症是一种罕见的常染色体隐性遗传病,导致胱氨酸从溶酶体中排出缺陷。Cystadrops(0.55%盐酸半胱氨酸粘性溶液)已被用于治疗胱氨酸贮积症患者角膜胱氨酸晶体蓄积,采用的是有条件批准用药。

方法

对 2013 年至 2017 年期间在法国接受 Cystadrops 治疗的 130 名患者的临时使用授权队列进行回顾性分析。

结果

患者平均每天每只眼滴注 3.3(±0.94)滴。在长达 45 个月的随访期间,患者的视力保持在 0.0 分,接近正常。角膜胱氨酸晶体评分随时间推移呈下降趋势,在 27 个月左右稳定在 1.22 至 1.87 之间。畏光在 3 个月内得到改善,稳定在 1.5 和 1.7 分左右。共报告了 47 例非严重不良反应,一般为短暂性刺激、刺痛或视力模糊。报告了 4 例严重不良事件,包括角膜炎和角膜溃疡,但这些可能是由基础疾病引起的。

结论

这项大型安全性队列研究证实了 Cystadrops 在真实世界临床实践中的疗效、安全性和耐受性。

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