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奥昔拉治疗伴有全身炎症反应综合征的急性胰腺炎患者:钙释放激活钙通道抑制剂的临床开发。

Auxora for the Treatment of Patients With Acute Pancreatitis and Accompanying Systemic Inflammatory Response Syndrome: Clinical Development of a Calcium Release-Activated Calcium Channel Inhibitor.

机构信息

Department of Emergency Medicine, Wayne State University, Detroit, MI.

Department of Radiology, St. Antonius Hospital, Nieuwegein, The Netherlands.

出版信息

Pancreas. 2021 Apr 1;50(4):537-543. doi: 10.1097/MPA.0000000000001793.

Abstract

OBJECTIVES

To assess the safety of Auxora in patients with acute pancreatitis (AP), systemic inflammatory response syndrome (SIRS), and hypoxemia, and identify efficacy endpoints to prospectively test in future studies.

METHODS

This phase 2, open-label, dose-response study randomized patients with AP, accompanying SIRS, and hypoxemia (n = 21) to receive low-dose or high-dose Auxora plus standard of care (SOC) or SOC alone. All patients received pancreatic contrast-enhanced computed tomography scans at screenings, day 5/discharge, and as clinically required 90 days postrandomization; scans were blinded and centrally read to determine AP severity using computed tomography severity index. Solid food tolerance was assessed at every meal and SIRS every 12 hours.

RESULTS

The number of patients experiencing serious adverse events was not increased with Auxora versus SOC alone. Three (36.5%) patients with moderate AP receiving low-dose Auxora improved to mild AP; no computed tomography severity index improvements were observed with SOC. By study end, patients receiving Auxora better tolerated solid foods, had less persistent SIRS, and had reduced hospitalization versus SOC.

CONCLUSIONS

The favorable safety profile and patient outcomes suggest Auxora may be an appropriate early treatment for patients with AP and SIRS. Clinical development will continue in a randomized, controlled, blinded, dose-ranging study.

摘要

目的

评估 Auxora 在伴有全身炎症反应综合征(SIRS)和低氧血症的急性胰腺炎(AP)患者中的安全性,并确定未来研究中进行前瞻性测试的疗效终点。

方法

这是一项 2 期、开放标签、剂量反应研究,将伴有 SIRS 和低氧血症的 AP 患者(n=21)随机分为低剂量或高剂量 Auxora 联合标准治疗(SOC)或单独 SOC 组。所有患者在筛查时、第 5 天/出院时以及随机分组后 90 天内按需进行胰腺增强 CT 扫描;扫描结果为盲态,并由中心阅片,以使用 CT 严重程度指数确定 AP 严重程度。每餐评估固体食物耐受性,每 12 小时评估 SIRS。

结果

与单独 SOC 相比,Auxora 并未增加患者发生严重不良事件的数量。3 名(36.5%)接受低剂量 Auxora 的中度 AP 患者改善为轻度 AP;SOC 未观察到 CT 严重程度指数改善。研究结束时,与 SOC 相比,接受 Auxora 的患者能够更好地耐受固体食物,持续的 SIRS 更少,住院时间更短。

结论

Auxora 良好的安全性和患者结局表明,它可能是 AP 和 SIRS 患者的一种合适的早期治疗方法。临床开发将继续在一项随机、对照、盲法、剂量范围研究中进行。

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