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体重指数对口服贝沙罗汀治疗伴高甘油三酯血症的影响:一项开放性比较临床研究的事后分析,比较了贝沙罗汀联合光疗与贝沙罗汀单药治疗日本皮肤 T 细胞淋巴瘤患者。

Effects of Body Mass Index on Hypertriglyceridemia Associated with Oral Bexarotene Therapy: A Post Hoc Analysis of an Open-Label Comparative Clinical Study of Combined Bexarotene and Phototherapy Versus Bexarotene Monotherapy for Japanese Patients with Cutaneous T-Cell Lymphoma.

机构信息

Department of Pharmacy, Nagoya City University Hospital, 1-Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.

Department of Clinical Pharmaceutics, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8602, Japan.

出版信息

Drugs R D. 2024 Jun;24(2):227-238. doi: 10.1007/s40268-024-00465-7. Epub 2024 Jun 13.

Abstract

BACKGROUND

Bexarotene, which has been approved for use in Japan since 2016, is an effective drug for cutaneous T-cell lymphoma; however, careful management is imperative because of its adverse events. We previously demonstrated the severity of bexarotene-associated hypertriglyceridemia and the need for bexarotene dose reduction for patients with cutaneous T-cell lymphoma and high body mass index (BMI); however, high BMI does not affect the efficacy of combined bexarotene and phototherapy treatment.

OBJECTIVE

This study aimed to verify the effects of BMI on hypertriglyceridemia associated with oral bexarotene therapy.

METHODS

We conducted a post hoc analysis of data from a previous randomized, open-label clinical study that compared combined bexarotene-phototherapy treatment with bexarotene monotherapy for cutaneous T-cell lymphoma by dividing patients into two groups based on BMI (<23 kg/m and ≥23 kg/m).

RESULTS

No statistically significant association was observed between patients with BMI ≥23 kg/m and severe hypertriglyceridemia; however, there was a significant association between BMI ≥23 kg/m and severe hypertriglyceridemia for patients who received bexarotene monotherapy, but not for those who received combined bexarotene-phototherapy treatment. The exact reasons for the discrepancies between the results of this thorough analysis and those of our past research are unclear. However, high BMI may be a risk factor for hypertriglyceridemia. Additional unidentified risk factors could also affect treatment outcomes.

CONCLUSION

High BMI is the primary reason for hypertriglyceridemia-associated bexarotene dose reduction; however, unexplored risk factors other than high BMI could exist.

摘要

背景

倍他罗汀自 2016 年在日本获批上市以来,是一种治疗皮肤 T 细胞淋巴瘤的有效药物;然而,由于其不良反应,必须谨慎管理。我们之前已经证明了倍他罗汀相关的高甘油三酯血症的严重程度,以及对于患有皮肤 T 细胞淋巴瘤和高体重指数(BMI)的患者需要减少倍他罗汀剂量;然而,高 BMI 并不影响联合倍他罗汀和光疗治疗的疗效。

目的

本研究旨在验证 BMI 对口服倍他罗汀治疗相关高甘油三酯血症的影响。

方法

我们对以前的一项随机、开放标签的临床研究数据进行了事后分析,该研究通过将患者根据 BMI(<23kg/m 和≥23kg/m)分为两组,比较了联合倍他罗汀-光疗治疗与倍他罗汀单药治疗皮肤 T 细胞淋巴瘤的疗效。

结果

在 BMI≥23kg/m 的患者中,与严重高甘油三酯血症之间没有观察到统计学上的显著关联;然而,在接受倍他罗汀单药治疗的患者中,BMI≥23kg/m 与严重高甘油三酯血症之间存在显著关联,而在接受联合倍他罗汀-光疗治疗的患者中则没有。造成这一全面分析结果与我们过去研究结果不一致的确切原因尚不清楚。然而,高 BMI 可能是高甘油三酯血症的一个危险因素。其他未被发现的危险因素也可能影响治疗结果。

结论

高 BMI 是导致与倍他罗汀相关的高甘油三酯血症需要减少剂量的主要原因;然而,除了高 BMI 之外,可能还存在其他未被探索的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3714/11315873/2d22203d706f/40268_2024_465_Fig1_HTML.jpg

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