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全身参数和基线特征在初治新生血管性年龄相关性黄斑变性患者玻璃体内注射雷珠单抗短期反应分析中的作用

The Effect of Systemic Parameters and Baseline Characteristics in Short-Term Response Analysis with Intravitreal Ranibizumab in Treatment-Naive Patients with Neovascular Age-Related Macular Degeneration.

作者信息

García-Quintanilla Laura, Almuiña-Varela Pablo, Rodríguez-Cid María José, Gil-Martínez María, Abraldes Maximino J, Gómez-Ulla Francisco, González-Barcia Miguel, Mondelo-García Cristina, Estany-Gestal Ana, Otero-Espinar Francisco J, Fernández-Rodríguez Maribel, Fernández-Ferreiro Anxo

机构信息

Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain.

Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain.

出版信息

Pharmaceutics. 2024 Jan 13;16(1):105. doi: 10.3390/pharmaceutics16010105.

Abstract

Anti-vascular endothelial growth factor drugs keep being the main therapy for neovascular age-related macular degeneration (AMD). Possible predictive parameters (demographic, biochemical and/or inflammatory) could anticipate short-term treatment response with ranibizumab. 46 treatment-naive patients were included in a prospective observational study. They underwent three monthly injections of intravitreal ranibizumab for neovascular AMD and the clinical examination was made at baseline and one month after the third injection. Demographic characteristics, co-morbidities and concomitant treatments were recorded at the baseline visit. Biochemical parameters, complete blood count and inflammation biomarkers were also measured at these times. Uric Acid was found to be statistically significant with a one-point difference between good and poor responders in both basal and treated patients, but only in basal parameters was statistical significance reached ( = 0.007 vs. = 0.071 in treated patients). Cholesterol and inflammatory parameters such as white blood cell count and neutrophils were significantly reduced over time when treated with intravitreal ranibizumab. On the other hand, women seemed to have a worse prognosis for short-term response to intravitreal ranibizumab treatment. Uric acid may help identify possible non-responders before initial treatment with ranibizumab, and cholesterol and white blood cells could be good candidates to monitor short-term response to ranibizumab treatment.

摘要

抗血管内皮生长因子药物一直是新生血管性年龄相关性黄斑变性(AMD)的主要治疗方法。可能的预测参数(人口统计学、生化和/或炎症指标)可以预测雷珠单抗的短期治疗反应。46例初治患者纳入一项前瞻性观察性研究。他们接受了三个月每月一次的玻璃体内注射雷珠单抗治疗新生血管性AMD,并在基线和第三次注射后1个月进行临床检查。在基线访视时记录人口统计学特征、合并症和伴随治疗情况。在这些时间点还测量了生化参数、全血细胞计数和炎症生物标志物。发现尿酸具有统计学意义,在基线和治疗后的患者中,良好和不良反应者之间相差1个点,但仅在基线参数中达到统计学意义(治疗后患者分别为P = 0.007和P = 0.071)。当用玻璃体内注射雷珠单抗治疗时,胆固醇和炎症参数如白细胞计数和中性粒细胞随时间显著降低。另一方面,女性似乎对玻璃体内注射雷珠单抗治疗的短期反应预后较差。尿酸可能有助于在使用雷珠单抗初始治疗前识别可能的无反应者,胆固醇和白细胞可能是监测雷珠单抗治疗短期反应的良好指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dce3/10818382/89dff70169c9/pharmaceutics-16-00105-g001.jpg

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