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用 ARRY-371797 治疗肌联蛋白基因(LMNA)缺陷性扩张型心肌病的长期疗效:通俗易懂的总结。

Long-term effectiveness of ARRY-371797 in people with dilated cardiomyopathy and a faulty LMNA gene: a plain language summary.

机构信息

Medical University of South Carolina, Cardiovascular Genetics, Charleston, SC, USA.

University of Colorado, Department of Medicine, Adult Medical Genetics Program, Aurora, CO, USA.

出版信息

Future Cardiol. 2023 Mar;19(3):117-126. doi: 10.2217/fca-2022-0125. Epub 2023 Apr 3.

DOI:10.2217/fca-2022-0125
PMID:37010012
Abstract

WHAT IS THIS PLAIN LANGUAGE SUMMARY ABOUT?: This summary explains the results of a long-term extension study on the effects of a specific medicine. A long-term extension study allows people who have already completed a research study to continue taking treatment. Researchers can then look at how a treatment works over a long period of time. This extension study looked at the effects of a medicine called ARRY-371797 (also known as PF-07265803) in people with dilated cardiomyopathy (DCM for short) caused by a faulty lamin A/C gene (also known as the LMNA gene). This condition is called LMNA-related DCM. In people with LMNA-related DCM, the heart muscle becomes thinner and weaker than normal. This can lead to heart failure, where the heart is unable to pump enough blood around the body. The extension study allowed people who had completed an earlier 48-week study to continue taking ARRY-371797 for another 96 weeks (around 22 months).

WHAT WERE THE RESULTS OF THE EXTENSION STUDY?: 8 people joined the extension study and continued with the dose of ARRY-371797 that they had taken in the first study. This means that people could have taken ARRY-371797 continuously for up to 144 weeks (around 2 years and 9 months). Using the 6-minute walk test (6MWT for short), researchers regularly checked people taking ARRY-371797 to see how far they could walk. Throughout the extension study, people were able to walk further than they could before they started taking ARRY-371797. This suggests that people could maintain the improvements in their ability to do daily activities with long-term ARRY-371797 treatment. Researchers also looked at how severe people's heart failure was by using a test that measures levels of a biomarker called NT-proBNP. A biomarker is something found in the body that can be measured to indicate the extent of a disease. Throughout this study, the levels of NT-proBNP in people's blood was lower than before they started taking ARRY-371797. This suggests that they maintained stable heart function. Using the Kansas City Cardiomyopathy Questionnaire (KCCQ for short), researchers asked people about their quality of life, and if they experienced any side effects. A side effect is something that people feel while taking a treatment. Researchers evaluate if a side effect is related to the treatment or not. Some improvement in KCCQ response during the study was seen, although results were varied. There were no serious side effects that were considered related to treatment with ARRY-371797.

WHAT DO THE RESULTS OF THE EXTENSION STUDY MEAN?: Researchers found that the improvements in functional capacity and heart function seen with ARRY-371797 treatment in the original study were maintained with long-term treatment. Larger studies are needed to determine if ARRY-371797 could be an effective treatment for people with LMNA-related DCM. One such study (called REALM-DCM) was started in 2018 but ended early, as it was unlikely to show a clear treatment benefit of ARRY-371797. Phase 2 long-term extension study (NCT02351856) Phase 2 study (NCT02057341) Phase 3 REALM-DCM study (NCT03439514).

摘要

这篇简体中文摘要解释了一项特定药物长期扩展研究的结果。长期扩展研究允许已经完成研究的人继续接受治疗。研究人员可以观察治疗在很长一段时间内的效果。这项扩展研究观察了一种名为 ARRY-371797(也称为 PF-07265803)的药物在由错误的 lamin A/C 基因(也称为 LMNA 基因)引起的扩张型心肌病(简称 DCM)患者中的作用。这种情况称为 LMNA 相关的 DCM。在患有 LMNA 相关 DCM 的人中,心肌比正常情况下变薄变弱。这可能导致心力衰竭,即心脏无法将足够的血液泵送到全身。这项扩展研究允许已经完成了为期 48 周的早期研究的人继续服用 ARRY-371797,再进行 96 周(约 22 个月)的治疗。

这项扩展研究的结果是什么?8 人参加了扩展研究,并继续服用他们在第一项研究中服用的 ARRY-371797 剂量。这意味着人们最多可以连续服用 ARRY-371797 144 周(约 2 年 9 个月)。通过使用 6 分钟步行测试(简称 6MWT),研究人员定期检查服用 ARRY-371797 的人的行走距离。在整个扩展研究期间,服用 ARRY-371797 的人能够比开始服用 ARRY-371797 之前走得更远。这表明人们可以通过长期服用 ARRY-371797 来维持他们日常活动能力的改善。研究人员还通过测量一种称为 NT-proBNP 的生物标志物的水平来观察人们的心力衰竭的严重程度。生物标志物是体内可以测量以指示疾病程度的物质。在整个研究过程中,人们血液中的 NT-proBNP 水平低于开始服用 ARRY-371797 之前。这表明他们保持了稳定的心脏功能。研究人员使用堪萨斯城心肌病问卷(简称 KCCQ)询问了人们的生活质量和是否有任何副作用。副作用是人们在接受治疗时所感受到的。研究人员评估副作用是否与治疗有关。在研究过程中观察到 KCCQ 反应的一些改善,尽管结果各不相同。没有与 ARRY-371797 治疗相关的严重副作用。

这项扩展研究的结果意味着什么?研究人员发现,在最初的研究中,使用 ARRY-371797 治疗观察到的功能能力和心脏功能的改善在长期治疗中得以维持。需要更大规模的研究来确定 ARRY-371797 是否可以成为治疗 LMNA 相关 DCM 的有效方法。一项名为 REALM-DCM 的此类研究于 2018 年开始,但提前结束,因为不太可能显示 ARRY-371797 的明确治疗益处。

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Characterization and natural history of patients with LMNA-related dilated cardiomyopathy in the phase 3 REALM-DCM trial.
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ESC Heart Fail. 2024 Dec;11(6):4201-4208. doi: 10.1002/ehf2.14955. Epub 2024 Aug 15.