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特杜格鲁肽在成年日本短肠综合征和肠衰竭患者中的疗效、安全性和药代动力学:两项扩展的 III 期研究。

Efficacy, safety, and pharmacokinetics of teduglutide in adult Japanese patients with short bowel syndrome and intestinal failure: two phase III studies with an extension.

机构信息

Osaka Medical and Pharmaceutical University, Osaka, Japan.

Tohoku University Hospital, Sendai, Miyagi, Japan.

出版信息

Surg Today. 2023 Mar;53(3):347-359. doi: 10.1007/s00595-022-02587-4. Epub 2022 Oct 6.

DOI:10.1007/s00595-022-02587-4
PMID:36201060
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9950205/
Abstract

PURPOSE

The short- and long-term efficacy, safety, and pharmacokinetics of teduglutide were analyzed in adult Japanese patients with short bowel syndrome and intestinal failure (SBS-IF).

METHODS

Patients received teduglutide 0.05 mg/kg/day in clinical trials (TED-C14-004, SHP633-306, and extension SHP633-307). Data were analyzed at 24 weeks and an interim data cut-off of 4.5 years.

RESULTS

The parenteral support (PS) volume decreased by ≥ 20% for 9/18 patients at 24 weeks and in all 11 patients by data cut-off in SHP633-307. The mean (standard deviation) PS volume decreased from baseline at 24 weeks in TED-C14-004 (-30.1 ± 25.9%) and SHP633-306 (-25.6 ± 25.5%), and at data cut-off in SHP633-307 (-57.08 ± 28.49%). Teduglutide was absorbed quickly. The adverse events were consistent with the underlying disease and known adverse drug reactions. Anti-teduglutide antibody titers declined with long-term treatment.

CONCLUSIONS

In Japanese adults with SBS-IF, teduglutide treatment was associated with clinically meaningful reductions in PS requirements, similar to findings in prior international studies. No new safety concerns specific to the Japanese SBS-IF patient population were identified with short- or long-term teduglutide treatment. Anti-teduglutide antibody titers disappeared in most Japanese adults with long-term treatment. These results constitute the longest evaluation of teduglutide treatment within clinical trials reported to date.

摘要

目的

分析短肠综合征和肠衰竭(SBS-IF)成年日本患者应用特杜鲁肽的短期和长期疗效、安全性和药代动力学。

方法

患者在临床试验(TED-C14-004、SHP633-306 和扩展 SHP633-307)中接受特杜鲁肽 0.05mg/kg/天治疗。在 24 周和 4.5 年的中期数据截止时进行数据分析。

结果

在 SHP633-307 中,24 周时 9/18 例患者和所有 11 例患者的肠外支持(PS)量减少了≥20%。在 TED-C14-004(-30.1±25.9%)和 SHP633-306(-25.6±25.5%)中,PS 量从基线开始下降,24 周时 PS 量下降,在 SHP633-307 中,数据截止时 PS 量下降(-57.08±28.49%)。特杜鲁肽吸收迅速。不良事件与基础疾病和已知的药物不良反应一致。随着长期治疗,抗特杜鲁肽抗体滴度下降。

结论

在 SBS-IF 的日本成年人中,特杜鲁肽治疗与 PS 需求的临床显著减少相关,与之前的国际研究结果相似。在接受特杜鲁肽短期或长期治疗的日本 SBS-IF 患者中,未发现新的特定安全性问题。在长期治疗的大多数日本成年人中,抗特杜鲁肽抗体滴度消失。这些结果构成了迄今为止临床试验中报道的特杜鲁肽治疗最长时间的评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38d6/9950205/4a7fab619965/595_2022_2587_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38d6/9950205/ae00bc83b5e3/595_2022_2587_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38d6/9950205/195bc325c2c8/595_2022_2587_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38d6/9950205/4a7fab619965/595_2022_2587_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38d6/9950205/ae00bc83b5e3/595_2022_2587_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38d6/9950205/195bc325c2c8/595_2022_2587_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38d6/9950205/4a7fab619965/595_2022_2587_Fig3_HTML.jpg

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Inter-ethnic differences in pharmacokinetics-is there more that unites than divides?种族间药代动力学的差异——有更多的共同点还是更多的分歧?
Pharmacol Res Perspect. 2021 Dec;9(6):e00890. doi: 10.1002/prp2.890.
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Mechanism of fibrosis and stricture formation in Crohn's disease.
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