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镰状细胞病药物治疗的不断变化的格局。

The Evolving Landscape of Drug Therapies for Sickle Cell Disease.

机构信息

Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN, USA.

Department of Hematology, Levine Cancer Institute - Atrium Health, Charlotte, NC, USA.

出版信息

Hematol Oncol Clin North Am. 2022 Dec;36(6):1285-1312. doi: 10.1016/j.hoc.2022.06.008.

Abstract

Although sickle cell disease can be cured using allogeneic hematopoietic stem cell transplantation and possibly gene therapy and gene editing, these treatments remain unavailable to most patients. As understanding of the disease pathophysiology increases, progress is being made in developing drug therapies. Hydroxyurea, l-glutamine, crizanlizumab, and voxelotor are currently approved by the US Food and Drug Administration, with multiple others at various stages of testing. With the limited efficacy of individual agents, combinations of agents will likely be required for optimal outcomes. Clinical and surrogate endpoints, other than vaso-occlusive crisis, are increasingly being considered in the evaluation of novel drugs.

摘要

虽然镰状细胞病可以通过异体造血干细胞移植和可能的基因治疗和基因编辑来治愈,但这些治疗方法对大多数患者来说仍然无法获得。随着对疾病病理生理学的理解不断加深,开发药物治疗方法取得了进展。羟基脲、L-谷氨酰胺、crizanlizumab 和 voxelotor 目前已获得美国食品和药物管理局批准,还有多种其他药物处于不同的测试阶段。由于单个药物的疗效有限,为了获得最佳效果,可能需要联合使用多种药物。除血管阻塞危象外,临床和替代终点也越来越多地被用于评估新型药物。

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