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对与红细胞生成性和X连锁原卟啉症相关的患者概况、临床特征、治疗模式及结局的真实世界评估。

Real-world assessment of the patient profile, clinical characteristics, treatment patterns, and outcomes associated with erythropoietic and X-linked protoporphyria.

作者信息

Silver Samuel M, Houghton Katherine, Hitchens Abby, Ansquer Valérie Derrien, Ciepielewska Malgorzata

机构信息

University of Michigan Medical School, Ann Arbor, Michigan, USA.

RTI Health Solutions, Manchester, UK.

出版信息

J Dermatol. 2025 Mar;52(3):416-422. doi: 10.1111/1346-8138.17607. Epub 2025 Jan 6.

DOI:10.1111/1346-8138.17607
PMID:39760298
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11883737/
Abstract

Erythropoietic protoporphyria (EPP) and X-linked protoporphyria (XLP) are rare genetic disorders. There are limited data regarding how these disorders are managed in real-world settings. The aim of this study was to document the characteristics and treatment patterns among patients diagnosed with EPP or XLP in general real-world settings in the United States. We, therefore, conducted a retrospective medical record review of patients diagnosed with EPP or XLP on or before July 1, 2020. Data were analyzed for patients with EPP (n = 299) and XLP (n = 91). Outcomes included demographic and clinical characteristics, diagnostic testing, therapy recommendations, office visits, emergency department visits, and hospitalizations. Costs were assigned to healthcare resources. Mean (standard deviation [SD]; median) time between the first symptom documented in the medical records and diagnosis was 2.9 (5.1; 1.3) years. The most common pre-diagnostic tests were liver function, total plasma and erythrocyte protoporphyrin, genetic tests, and renal function. Patients were advised to use sunscreen (85%) or modify their lifestyle (83%). Within 12 months of diagnosis, the mean (SD; median) number of office visits, emergency department visits, and inpatient hospitalizations related to EPP or XLP were 4.0 (3.5; 3.0), 0.8 (1.6; 0), and 0.4 (1.3; 0), respectively. Patients with EPP or XLP have several unmet needs, including timely and accurate diagnosis, symptom relief, and efficacious prevention of phototoxic reactions.

摘要

红细胞生成性原卟啉病(EPP)和X连锁原卟啉病(XLP)是罕见的遗传性疾病。关于这些疾病在现实环境中的管理方式,相关数据有限。本研究的目的是记录在美国一般现实环境中被诊断为EPP或XLP的患者的特征和治疗模式。因此,我们对在2020年7月1日或之前被诊断为EPP或XLP的患者进行了回顾性病历审查。对EPP患者(n = 299)和XLP患者(n = 91)的数据进行了分析。结果包括人口统计学和临床特征、诊断测试、治疗建议、门诊就诊、急诊科就诊和住院情况。成本被分配到医疗资源上。病历中记录的首次症状与诊断之间的平均(标准差[SD];中位数)时间为2.9(5.1;1.3)年。最常见的诊断前测试是肝功能、总血浆和红细胞原卟啉、基因测试和肾功能。建议患者使用防晒霜(85%)或改变生活方式(83%)。在诊断后的12个月内,与EPP或XLP相关的门诊就诊、急诊科就诊和住院的平均(SD;中位数)次数分别为4.0(3.5;3.0)、0.8(1.6;0)和0.4(1.3;0)。EPP或XLP患者有一些未满足的需求,包括及时准确的诊断、症状缓解以及有效预防光毒性反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7f4/11883737/7cf67c02b568/JDE-52-416-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7f4/11883737/ac4c3f6ac98a/JDE-52-416-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7f4/11883737/b37549d17539/JDE-52-416-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7f4/11883737/7cf67c02b568/JDE-52-416-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7f4/11883737/ac4c3f6ac98a/JDE-52-416-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7f4/11883737/b37549d17539/JDE-52-416-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7f4/11883737/7cf67c02b568/JDE-52-416-g002.jpg

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本文引用的文献

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J Am Acad Dermatol. 2023 Dec;89(6):1227-1237. doi: 10.1016/j.jaad.2022.08.036. Epub 2022 Aug 27.
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Recognized and Emerging Features of Erythropoietic and X-Linked Protoporphyria.红细胞生成性和X连锁原卟啉症的已知及新出现特征
Diagnostics (Basel). 2022 Jan 8;12(1):151. doi: 10.3390/diagnostics12010151.
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Laboratory Diagnosis of Porphyria.
卟啉病的实验室诊断
Diagnostics (Basel). 2021 Jul 26;11(8):1343. doi: 10.3390/diagnostics11081343.
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Erythropoietic protoporphyria: time to prodrome, the warning signal to exit sun exposure without pain-a patient-reported outcome efficacy measure.红细胞生成性原卟啉病:从发病到前驱期的时间,即无痛离开阳光照射的警示信号——一项患者报告的疗效指标。
Genet Med. 2021 Sep;23(9):1616-1623. doi: 10.1038/s41436-021-01176-z. Epub 2021 May 3.
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Porphyria: awareness is the key to diagnosis!卟啉病:提高认识是诊断的关键!
Acta Clin Belg. 2022 Jun;77(3):703-709. doi: 10.1080/17843286.2021.1918876. Epub 2021 May 3.
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Clinical and molecular epidemiology of erythropoietic protoporphyria in Italy.意大利红细胞生成性原卟啉症的临床和分子流行病学。
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Increased phototoxic burn tolerance time and quality of life in patients with erythropoietic protoporphyria treated with afamelanotide - a three years observational study.阿法美拉诺肽治疗红细胞生成性原卟啉症患者可增加光毒性烧伤耐受时间和生活质量:一项为期三年的观察性研究。
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