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评估小干扰核糖核酸分子吉沃西坦治疗急性间歇性卟啉症的疗效:一项系统评价

Evaluating the Efficacy of a Small Interfering Ribonucleic Acid Molecule, Givosiran, in Treating Acute Intermittent Porphyria: A Systematic Review.

作者信息

Patel Priyansh, Midha Sidharth, Shukla Surmai, Dhamija Divyanshu, Bello Adedamola O, Khan Safeera

机构信息

Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Internal Medicine, Medical College Baroda, Baroda, IND.

出版信息

Cureus. 2023 Jun 18;15(6):e40585. doi: 10.7759/cureus.40585. eCollection 2023 Jun.

Abstract

Acute intermittent porphyria (AIP) is a severe multiorgan dysfunction disorder that can be fatal if not treated promptly. The newest treatment modality involving small interfering RNA (siRNA) molecules, givosiran, is administered for AIP. Although it has very beneficial effects in treating attacks of AIP, it comes with an extensive side effect profile that is not fully understood or studied. Hence, this novel drug model treatment's risk-benefit evaluation is still necessary. For relevant medical literature, we explored medical databases such as PubMed/Medline, PubMed Central, Cochrane Library, Internet Archive Scholar, Google Scholar, and Wiley Online Library. The selected papers were screened based on eligibility criteria and filtered through quality appraisal tools, and 13 finalized research papers were included in the study. Of the 13 identified papers, three were clinical trials, and 10 were review articles. The selected papers all discussed the effectiveness and side effects of givosiran in acute and recurrent attacks of AIP. The research papers showed decreased rates of acute attacks of AIP with givosiran and terminating recurrent attacks. But there are certain non-serious side effects, like fatigue and nausea. Also, there are some severe side effects, like pain. There is limited information on renal and liver function impairment using givosiran and the use of givosiran in patients with kidney and liver disease, for which further studies are required.

摘要

急性间歇性卟啉病(AIP)是一种严重的多器官功能障碍性疾病,若不及时治疗可能会致命。最新的治疗方式是使用小干扰RNA(siRNA)分子givosiran来治疗AIP。尽管它在治疗AIP发作方面有非常有益的效果,但其副作用范围广泛,尚未得到充分了解或研究。因此,对这种新型药物模型治疗进行风险效益评估仍然很有必要。对于相关医学文献,我们检索了诸如PubMed/Medline、PubMed Central、Cochrane图书馆、互联网档案馆学者、谷歌学术和Wiley在线图书馆等医学数据库。根据入选标准对所选论文进行筛选,并通过质量评估工具进行过滤,最终有13篇研究论文纳入本研究。在这13篇已识别的论文中,3篇是临床试验,10篇是综述文章。所选论文均讨论了givosiran在AIP急性发作和复发发作中的有效性和副作用。研究论文表明,使用givosiran可降低AIP急性发作率并终止复发发作。但存在一些非严重副作用,如疲劳和恶心。也有一些严重副作用,如疼痛。关于使用givosiran导致肾和肝功能损害以及在肾病和肝病患者中使用givosiran的信息有限,对此需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8362/10353265/c40dcab9c10c/cureus-0015-00000040585-i01.jpg

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