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Chest:氯法齐明治疗原发性和难治性非结核分枝杆菌感染效果如何?

2017-11-17 应颖秋 环球医学

2017年10月,发表在《Chest》的一项由美国科学家进行的研究考察了氯法齐明治疗原发性和难治性非结核分枝杆菌(NTM)感染的安全性和有效性。

2017年10月,发表在《Chest》的一项由美国科学家进行的研究考察了氯法齐明治疗原发性和难治性非结核分枝杆菌(NTM)感染的安全性和有效性。

背景:氯法齐明是一种抗菌药物,具有体外抗分枝杆菌活性。氯法齐明越来越多的用于NTM的治疗,尽管支持其治疗的数据有限。本研究的目的为评估NTM感染患者中,与氯法齐明相关的安全性、耐受性和临床结局。

方法:该观察性队列研究评估了2006~2014年,氯法齐明作为多药治疗方案一部分,用于治疗具有肺和肺外NTM感染的儿童和成年囊性纤维化(CF)患者和非CF患者。记录治疗方案和不良药物反应(ADRs)。

结果:总共纳入了112例患者(中位年龄,62岁);24例(21%)患CF。87例(78%)患难治性疾病且既往治疗失败。54例(48%)具有脓肿分枝杆菌复合体,41例(37%)具有结核分枝杆菌复合体,16例(14%)具有两个NTM种群。氯法齐明使用的中位时间为383天(范围,3~2419天)。16名患者(14%)因中位101天(95% CI,63~119)后的ADR而停用氯法齐明。41/82例(50%)肺病患者在12个月内NTM培养结果转为阴性。

结论:在儿童和成年CF和非CF患者的异质性人群中,氯法齐明是安全、耐受性好的活性NTM感染口服药物。氯法齐明应被考虑作为NTM疾病治疗的替代药物。

原始出处:
Martiniano SL, Wagner BD, Levin A,et al.Safety and Effectiveness of Clofazimine for Primary and Refractory Nontuberculous Mycobacterial Infection.Chest. 2017 Oct;152(4):800-809. doi: 10.1016/j.chest.2017.04.175. Epub 2017 May 5.

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time=2017-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464333, encodeId=e7931464333f5, content=<a href='/topic/show?id=a12d6410ee3' target=_blank style='color:#2F92EE;'>#氯法齐明#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64107, encryptionId=a12d6410ee3, topicName=氯法齐明)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0faf6667314, createdName=surilei, createdTime=Sun Nov 19 08:12:00 CST 2017, time=2017-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528410, encodeId=424e1528410e9, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, 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    2018-01-17 Smile2680
  5. 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  6. 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time=2017-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464333, encodeId=e7931464333f5, content=<a href='/topic/show?id=a12d6410ee3' target=_blank style='color:#2F92EE;'>#氯法齐明#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64107, encryptionId=a12d6410ee3, topicName=氯法齐明)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0faf6667314, createdName=surilei, createdTime=Sun Nov 19 08:12:00 CST 2017, time=2017-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528410, encodeId=424e1528410e9, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, 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  7. 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  8. 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  9. 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time=2017-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464333, encodeId=e7931464333f5, content=<a href='/topic/show?id=a12d6410ee3' target=_blank style='color:#2F92EE;'>#氯法齐明#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64107, encryptionId=a12d6410ee3, topicName=氯法齐明)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0faf6667314, createdName=surilei, createdTime=Sun Nov 19 08:12:00 CST 2017, time=2017-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528410, encodeId=424e1528410e9, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, 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    2017-11-19 freve
  10. 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    2017-11-18 1dd8c52fm63(暂无匿称)

    学习学习.了解了解

    0

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Chest:难治性非结核分枝杆菌感染采用氯法齐明治疗的安全性和有效性分析!

由此可见,氯法齐明治疗是一种安全、耐受性良好并且对NTM感染有治疗活性的口服药物。它应作为非结核分枝杆菌病的治疗替代药物。

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