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Zvinoenderana neyakajairwa kuyedza kuEurope, yemazuva ano intravenous iron replacement therapy yakakonzera chiitiko chepamusoro che hypophosphatemia muvarwere vane anemia yakabatana nechirwere chekuzvimba (IBD), zvisinei nemhedzisiro yakafanana pahemoglobin nezvitoro zvesimbi.
Heinz Zoller, MD, anoshuma kuti muPHOSPHARE-IBD ​​yekudzidza ye97 IBD varwere vane iron inoshaya anemia yakarongerwa iron carboxymaltose (FCM; Injectafer) versus iron demethylmaltose (FDI; Monoferric).yakakwirira muvarwere., Medical University yeInnsbruck, Austria, uye vaunoshanda navo.
Kubva pakutanga kusvika kuzuva 35, 51% yevarwere veFCM uye 8.3% yevarwere veFDI vaiva ne hypophosphatemia chero nguva, sezvinoratidzwa neserum phosphate mazinga ari pasi pe 2.0 mg / dL (yakagadziriswa musiyano wengozi - 42.8, 95% CI -57.1 kusvika -24.6 ), P<0,0001), — написала группа в Gut. , P<0.0001), boka rakanyora muna Gut.
Vatsvakurudzi vakashandisa madosi akafanana zvichienderana nehemoglobin uye uremu hwemuviri kune zvese zvigadzirwa kuti zvibvise zvingangovhiringidza zvinhu mumiedzo yapfuura. Chiitiko chepamusoro che hypophosphatemia chakaitika mukati memavhiki ekutanga e2 ekuputira, uye yakaramba yakasimudzwa muboka reFCM mumazuva makumi manomwe (59.2% vs 12.5%, P <0.0001). Chiitiko chepamusoro che hypophosphatemia chakaitika mukati memavhiki ekutanga e2 ekuputira, uye yakaramba yakasimudzwa muboka reFCM mumazuva makumi manomwe (59.2% vs 12.5%, P <0.0001). Самая высокая частота гипофосфатемии возникла в течение первых 2 недель инфузии и оставалась повышенной в групофосфатемии возникла в течение первых 2 недель инфузии и оставалась повышенной в групофосфатемии возникла в течение первых 2. Chiitiko chepamusoro che hypophosphatemia chakaitika mukati memavhiki ekutanga e2 ekuputira uye yakaramba yakasimudzwa muboka reFCM mushure memazuva makumi manomwe (59.2% vs 12.5%, P <0.0001).低磷血症的最高发生率发生在输注的前2 周内，并且在FCM 组在70 天时仍然升高（59.5% vs 12.低磷血症的最高发生率发生在输注的前2 周内，并且在FCM 组在70 天时仍然升高（59.0% vs 12.5%,0P Самая высокая частота гипофосфатемии возникла в течение первых 2 недель инфузии и оставалась повышенной в тегефосфатемии возникла в течение первых 2 недель инфузии и оставалась повышенной в тегефосфатемии возникла в течение первых 2 недель инфузии и оставалась повышенной в тегефосфатемии возникла в течение первых 2. Chiitiko chepamusoro che hypophosphatemia chakaitika mukati memavhiki ekutanga e2 ekuputira uye yakaramba yakasimudzwa kwemazuva makumi manomwe muboka re FCM (59.2% vs 12.5%, P <0.0001).
"Pasinei nekushanda kwakafanana uye pasina misiyano mukusagadzikana kweallergies, maviri anonyanya kushandiswa emazuva ano emutsinga gadziriro yesimbi muEurope ane yakajeka chengetedzo profiles, sezvo desmethylmaltose iron inogona kutorwa segadziriro yakachengeteka," Zoller akaudza MedPage Nhasi.
Iron deficiency anemia ndiyo yakajairika extraintestinal complication yeBD inogona kukanganisa kushanda kwemuviri uye yekuziva uye kuwedzera njodzi yekuiswa muchipatara.Sezvambotaurwa, FCM neFDI yakaratidza kushanda kwakafanana mukugadzirisa iron inoshaya anemia ine inenge yakafanana kuwedzera kwehemoglobin mushure memazuva 70 (25.2 uye 24.9 g / l, maererano).
Kusiyana kwechiitiko che hypophosphatemia pakati pemishonga miviri yekutsiva iron yakaonekwa munguva yakapfuura yakatsanangurwa nekuoma kana etiology yekushaya simbi, kushanda kwetsvo yevarwere, uye maitiro akasiyana-siyana emishonga yemishonga inopinza..Muyedzo wekare wekuenzanisa marapirwo maviri ekutsiva simbi, kuyedza kweUS PHOSPHARE-IDA, yakaratidzawo chiitiko chepamusoro che hypophosphatemia muFCM, kunyangwe madosi uye marongero edosing aisiyana zvichienderana neakakodzera FDA-yakatenderwa ruzivo rwekuraira.
"Ongororo yemazuva ano yakaratidzawo kuti, pasinei nekupora kubva ku hypophosphatemia, nzira yekuputika kwekuchinja kwehupenyu hunobatanidza nekutaura kwepamusoro kweFGF23 [fibroblast growth factor 23], inonzi "6H syndrome", yakasununguka kune varwere vanogamuchira FCM," Zoller.uye vaaishanda navo vakanyora.
"Kunyanya, bone-specific [alkaline phosphatase] yakaramba yakasimudzwa muboka reFCM richienzaniswa neboka reFDI pazuva 70, zvichireva kuti FCM yakakanganisa kuchinja kwemapfupa mukati mekuedza uye mberi," vakaenderera mberi."Izvi zviwanikwa zvinogona kubatanidza hypophosphatemia neosteomalacia, dambudziko riri kukura reFCM iro rachangobva kunyorwa seyambiro yakakosha muruzivo rweEurope kune varwere vane FCM."
Zoller akaudza MedPage Nhasi kuti kumwe kutsvagisa "kwakanangana nekunzwisisa kuti sei mishonga miviri iyi ichisiyana mukupinzwa kwavo kweFGF23, hormone inokonzera mhinduro yakaoma inotungamira ku hypophosphatemia, kudzivirira kukura kwezvinodhaka."Kuve nemhedzisiro iyi uye nekunzwisisa dysregulation iyi. ".”
PHOSPHARE-IBD ​​​​muyedzo wakapetwa kaviri, wakasarudzika wevarwere ve97 IBD - 61% vane ulcerative colitis (UC) uye 39% vane chirwere cheCrohn's (CD) - muzvipatara makumi maviri zveEuropean kubvira 2018. 2020.
Varwere vakakodzera vaida serum ferritin level ye 100 ng / mL kana pasi, hemoglobin level isingasviki 130 g / L, uye inoda kukurumidza kuwedzera kwesimbi kana kuva nemuromo wesimbi kusawirirana / kusanzwa, pakati pemamwe maitiro.
Vatori vechikamu vakagadziriswa muchiyero che1: 1 kuti vagamuchire muyero wakafanana weFDI kana FCM zvichienderana nehemoglobin uye uremu hwemuviri pakutanga uye mazuva 35 gare gare.Kune varwere vane hemoglobin mazinga ari pasi pe100 g / l, chiyero chese 1500 mg kune varwere vane huremu huri pasi pe70 kg uye 2000 mg kune varwere vanorema 70 kg kana kupfuura.Varwere vane hemoglobin level ye100 g / l uye pamusoro vakagamuchira chiyero che 1500 mg.
Zoller nevamwe vaaishanda navo vakanyora kuti: “Tichifunga magadzirirwo echidzidzo ichi, zvinogona kugumiswa kuti kusiyana kwakaonekwa muchiitiko che hypophosphatemia kwakakonzerwa nekusiyana kwekugadzirwa kwesimbi, uye kwete kuhuwandu hwesimbi, dosing regimen, kusiyana kweCD. kuenzaniswa neUC.kana zvimwe zvinhu zvine chekuita nemurwere senge itsvo kushanda, kuomarara kwekuzvimba, dhigirii rekushomeka kwesimbi, kana kushomeka kwevhitamini D.
Makore epakati evarwere muchidzidzo aiva makore 42, 53% vaiva vakadzi, vazhinji vaiva vachena (86%), uye chiyero chemuviri wemuviri waiva 27.6.Muyero we hemoglobin wepakati pakutanga waiva 105 g/l.
Kuwanda kwezviitiko zvakashata (AEs) uye zviitiko zvakakomba zvakashata (AEs) zvakafanana kune zvigadzirwa zvakasiyana, asi zvizhinji zvacho zvaive zvinyoro (80-83%).Iboka reFCM rakanga rine huwandu hwevhitamini D hushoma (35% vs 23%) uye mamwe maitiro e nasopharyngitis (20% vs 17%) kupfuura boka reFDI.Muboka reFDI, misoro yemusoro (19% vs. 10%) yakanga yakawanda, sezvakaita kusvotwa (13% vs. 2%).Vamwe varwere muboka reFDI vakarega kurapwa nekuda kweAEs (6% vs 2%).
Kunyange zvazvo kupindira kwose kwakaguma nekuvandudzwa kwehuwandu hwekuneta-kwakataurwa nemurwere, kuvandudzwa kukuru uye nekukurumidza kwakaonekwa muboka reFDI, kunyange zvazvo kusiyana uku kwakarasikirwa nekukosha mushure memazuva makumi manomwe.
Kuganhurirwa kwedata kunosanganisira nguva pfupi yekutevera uye kusakwanisa kunyatsoongorora mhedzisiro yekiriniki.
Zaina Hamza ndiye MedPage Nhasi munyori wevashandi we gastroenterology uye zvirwere zvinotapukira.Iye anogara muChicago.
Zoller akazivisa mari kubva kuAbbvie, Bayer, Falk, Giriyedhi, Merz, Medice, Pierre Fabre, Pharmacosmos, Sanofi neVifor.Vanyori-vanyori vanotaura hukama nemakambani akati wandei emishonga nemaindasitiri.Mumwe munyori akashumawo vanyori-vanyori vezvibvumirano zvine chokuita negadziriro yesimbi yevabereki.
LINK kune SOURCE: Zoller H et al."Hypophosphatemia mushure mekutonga kwesimbi desferiomaltose uye iron carboxymaltose kune varwere vane iron inoshaya anemia nekuda kwechirwere chechirwere chechirwere (Phosphare-IBD): chirongwa chekliniki chisingaverengeki" Gut 2022;DOI: 10.1136/gutjnl-2022-327897.
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