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腹部主动脉瘤的治疗方法:临床试验概述。

Medical treatments for abdominal aortic aneurysm: an overview of clinical trials.

机构信息

Department of Vascular Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Expert Opin Investig Drugs. 2024 Sep;33(9):979-992. doi: 10.1080/13543784.2024.2377747. Epub 2024 Jul 11.

DOI:10.1080/13543784.2024.2377747
PMID:38978286
Abstract

INTRODUCTION

Abdominal aortic aneurysm is a progressive, segmental, abdominal aortic dilation associated with a high mortality rate. Abdominal aortic aneurysms with diameters larger than 55 mm are associated with a high risk of rupture, and the most effective treatment options are surgical repair. Close observation and lifestyle adjustments are recommended for smaller abdominal aortic aneurysms with lower rupture risk. The development of medical therapies that limit or prevent the progression, expansion, and eventual rupture of abdominal aortic aneurysms remains an unmet clinical need.

AREAS COVERED

This review provides an overview of completed and ongoing clinical trials examining the efficacies of various drug classes, including antibiotics, antihypertensive drugs, hypolipidemic drugs, hypoglycemic drugs, and other potential therapies for abdominal aortic aneurysms. A search of PubMed, Web of Science, Clinical Trials, and another six clinical trial registries was conducted in January 2024.

EXPERT OPINION

None of the drugs have enough evidence to indicate that they can effectively inhibit the dilation of abdominal aortic aneurysm. More clinical trial data is required to support the efficacy of propranolol. Future research should also explore different drug delivery mechanisms, such as nanoparticles, to elevate drug concentration at the aneurysm wall.

摘要

简介

腹主动脉瘤是一种进行性、节段性的腹主动脉扩张,其死亡率较高。直径大于 55mm 的腹主动脉瘤破裂风险较高,最有效的治疗选择是手术修复。对于破裂风险较低的较小腹主动脉瘤,建议密切观察和调整生活方式。限制或预防腹主动脉瘤进展、扩张和最终破裂的医学治疗方法的发展仍然是一个未满足的临床需求。

涵盖领域

本综述概述了已完成和正在进行的临床试验,这些试验检查了各种药物类别的疗效,包括抗生素、抗高血压药物、降脂药物、降血糖药物和其他潜在的腹主动脉瘤治疗方法。2024 年 1 月,在 PubMed、Web of Science、ClinicalTrials 和另外六个临床试验注册处进行了检索。

专家意见

没有一种药物有足够的证据表明它们能有效抑制腹主动脉瘤的扩张。需要更多的临床试验数据来支持普萘洛尔的疗效。未来的研究还应探索不同的药物输送机制,如纳米粒子,以提高在动脉瘤壁的药物浓度。

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