罗沙司他对肾性贫血患者甲状腺功能的影响。
Effect of Roxadustat on Thyroid Function in Patients With Renal Anemia.
机构信息
Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital, Osaka 553-0003, Japan.
Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kobe 650-0047, Japan.
出版信息
J Clin Endocrinol Metab. 2023 Dec 21;109(1):e69-e75. doi: 10.1210/clinem/dgad483.
CONTEXT
Roxadustat, a hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitor, a recently developed class of drugs for treatment of anemia in chronic kidney disease (CKD), is reported to have a structure unlike that of other HIF-PH inhibitors but similar to that of triiodothyronine and bind to the thyroid hormone receptor in vitro. However, reports on the effects of roxadustat on thyroid function are limited and not detailed, and it remains unknown whether other HIF-PH inhibitors also affect thyroid function.
OBJECTIVE
To compare the effect of roxadustat with daprodustat, another HIF-PH inhibitor, on thyroid function in patients with renal anemia in CKD.
METHODS
This retrospective observational study included a total of 26 patients with anemia in CKD who were treated with roxadustat or daprodustat; thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were measured before and after treatment with the drugs.
RESULTS
After initiation of roxadustat, TSH showed a significant decrease (2.4732 [1.7858-4.9016] μIU/mL before treatment and 0.659 [0.112-2.005] μIU/mL after treatment, P < .05); FT4 showed a significant decrease (0.93 [0.84-1.05] ng/dL before treatment and 0.70 [0.53-0.85] ng/dL after treatment, P < .01). After daprodustat initiation, neither TSH nor FT4 showed a significant change (TSH: 3.044 [1.853-4.171] μIU/mL before treatment and 2.893 [1.866-4.894] μIU/mL after treatment, P = .635; FT4 was 0.93 [0.81-1.00] ng/dL before treatment and 0.97 [0.87-1.05] ng/dL after treatment, P = .328).
CONCLUSION
Roxadustat decreases TSH and FT4 levels while daprodustat does not.
背景
罗沙司他是一种低氧诱导因子脯氨酰羟化酶（HIF-PH）抑制剂，是一种最近开发的用于治疗慢性肾脏病（CKD）贫血的药物，据报道，它的结构不同于其他 HIF-PH 抑制剂，但与三碘甲状腺原氨酸相似，并在体外与甲状腺激素受体结合。然而，关于罗沙司他对甲状腺功能影响的报告有限且不详细，目前尚不清楚其他 HIF-PH 抑制剂是否也会影响甲状腺功能。
目的
比较罗沙司他与另一种 HIF-PH 抑制剂 daprodustat 对 CKD 肾性贫血患者甲状腺功能的影响。
方法
本回顾性观察性研究共纳入 26 例接受罗沙司他或 daprodustat 治疗的 CKD 贫血患者；治疗前后测定促甲状腺激素（TSH）和游离甲状腺素（FT4）。
结果
罗沙司他治疗后 TSH 显著下降（治疗前 2.4732[1.7858-4.9016]μIU/mL，治疗后 0.659[0.112-2.005]μIU/mL，P<0.05）；FT4 显著下降（治疗前 0.93[0.84-1.05]ng/dL，治疗后 0.70[0.53-0.85]ng/dL，P<0.01）。daprodustat 治疗后 TSH 和 FT4 均无明显变化（TSH：治疗前 3.044[1.853-4.171]μIU/mL，治疗后 2.893[1.866-4.894]μIU/mL，P=0.635；FT4 治疗前 0.93[0.81-1.00]ng/dL，治疗后 0.97[0.87-1.05]ng/dL，P=0.328）。
结论
罗沙司他降低 TSH 和 FT4 水平，而 daprodustat 则没有。
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