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芦可替尼治疗对羟基脲耐药和/或不耐受的真性红细胞增多症患者:一项欧洲观察性研究。

Ruxolitinib in patients with polycythemia vera resistant and/or intolerant to hydroxyurea: European observational study.

机构信息

Department of Medical Oncology and Hematology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.

Department of Internal Medicine I, Hematology, Medical University of Vienna, Vienna, Austria.

出版信息

Eur J Haematol. 2024 Mar;112(3):379-391. doi: 10.1111/ejh.14124. Epub 2023 Oct 30.

Abstract

BACKGROUND

Hydroxyurea (HU) is a commonly used first-line treatment in patients with polycythemia vera (PV). However, approximately 15%-24% of PV patients report intolerance and resistance to HU.

METHODS

This phase IV, European, real-world, observational study assessed the efficacy and safety of ruxolitinib in PV patients who were resistant and/or intolerant to HU, with a 24-month follow-up. The primary objective was to describe the profile and disease burden of PV patients.

RESULTS

In the 350 enrolled patients, 70% were >60 years old. Most patients (59.4%) had received ≥1 phlebotomy in the 12 months prior to the first dose of ruxolitinib. Overall, 68.2% of patients achieved hematocrit control with 92.3% patients having hematocrit <45% and 35.4% achieved hematologic remission at month 24. 85.1% of patients had no phlebotomies during the study. Treatment-related adverse events were reported in 54.3% of patients and the most common event was anemia (22.6%). Of the 10 reported deaths, two were suspected to be study drug-related.

CONCLUSION

This study demonstrates that ruxolitinib treatment in PV maintains durable hematocrit control with a decrease in the number of phlebotomies in the majority of patients and was generally well tolerated.

摘要

背景

羟基脲(HU)是真性红细胞增多症(PV)患者的常用一线治疗药物。然而,约 15%-24%的 PV 患者报告对 HU 不耐受和耐药。

方法

这是一项在对 HU 耐药和/或不耐受的 PV 患者中评估芦可替尼疗效和安全性的 IV 期、欧洲、真实世界、观察性研究,随访 24 个月。主要目的是描述 PV 患者的特征和疾病负担。

结果

在纳入的 350 例患者中,70%的患者年龄>60 岁。大多数患者(59.4%)在接受芦可替尼首剂量前 12 个月内接受了≥1 次放血治疗。总体而言,68.2%的患者达到血细胞比容控制,92.3%的患者血细胞比容<45%,35.4%的患者在 24 个月时达到血液学缓解。85.1%的患者在研究期间无需放血治疗。54.3%的患者报告出现治疗相关不良事件,最常见的事件是贫血(22.6%)。在报告的 10 例死亡中,有 2 例疑似与研究药物有关。

结论

这项研究表明,芦可替尼治疗 PV 可维持持久的血细胞比容控制,大多数患者减少了放血次数,且总体耐受性良好。

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