歆医荟 - 欢迎加入,医药专家分享交流社区客服
首页关注
发布发布文章
搜索
泊帕争鸣时代下,各类小分子TPO-RA的药物特点
歆语健康发布于 2023-11-24 16:56
添加收藏专家

导 语


肿瘤药物相关血小板减少(CTIT)是肿瘤患者接受相关治疗时最常见的血液学不良反应之一,可增加出血风险、导致抗肿瘤治疗减量或延迟、延长住院时间、提高医疗费用,最终为患者的临床结局带来不利影响。
CTIT的主要治疗措施为输注血小板和应用促血小板生成药物。其中,促血小板生成药物包括重组人血小板生成素(rhTPO)、重组人白细胞介素11(rhIL-11)和血小板生成素受体激动剂(TPO‑RA)。在众多TPO-RA之间,艾曲泊帕、海曲泊帕和阿伐曲泊帕是目前临床最为常用的3种小分子TPO-RA,但这三种药物的结构、有效性、安全性和便利性方面略有不同。本文依次阐述这些药物的特点,旨在为临床医生选择升血小板药物提供参考。


​


参考文献:

1.中华医学会血液学分会血栓与止血学组. 促血小板生成药物临床应用管理中国专家共识(2023年版)[J]. 中华血液学杂志,2023,44(7):535-542.

2.Vlachodimitropoulou E, Chen YL, Garbowski M, et al. Eltrombopag: a powerful chelator of cellular or extracellular iron(III) alone or combined with a second chelator. Blood. 2017 Oct 26;130(17):1923-1933.

3.刘海龙,王江,林岱宗,等.先导化合物结构优化策略(二)——结构修饰降低潜在毒性[J].药学学报,2014,49(1):1-15.

4.艾曲泊帕乙醇胺片说明书.

5.牛子冉,左玮,邹羽真,等. 艾曲泊帕治疗儿童慢性免疫性血小板减少症的临床效果[J]. 临床药物治疗杂志,2020,18(7):62-66.

6.Winer ES, Safran H, Karaszewska B, et al. Eltrombopag with gemcitabine-based chemotherapy in patients with advanced solid tumors: a randomized phase I study. Cancer Med. 2015 Jan;4(1):16-26.

7.海曲泊帕乙醇胺片说明书.

8.Mei H, Liu X, Li Y, et al. Dose tapering to withdrawal stage and long-term efficacy and safety of hetrombopag for the treatment of immune thrombocytopenia: Results from an open-label extension study. J Thromb Haemost. 2022 Mar;20(3):716-728.

9.Dong Yan,Jing Yang, Yunfei Gao, et al; Combination of Thrombopoietin Receptor Agonist and Recombinant Human Thrombopoietin for Treating Cancer Therapy Induced Thrombopenia. Blood 2022; 140 (Supplement 1): 8420–8421.

10.陈灿,张其坤,许青. 新型血小板生成素受体激动剂:阿伐曲泊帕[J]. 中国新药与临床杂志,2020,39(11):652-656.

11.马来酸阿伐曲泊帕片说明书.

12.Nomoto M, Pastino G, Rege B, et al. Pharmacokinetics, Pharmacodynamics, Pharmacogenomics, Safety, and Tolerability of Avatrombopag in Healthy Japanese and White Subjects. Clin Pharmacol Drug Dev. 2018 Feb;7(2):188-195.

13.Kuter DJ. The structure, function, and clinical use of the thrombopoietin receptor agonist avatrombopag. Blood Rev. 2022 May;53:100909.

14.Cui Y, He Y, Hu C, et al. Avatrombopag for the treatment of thrombocytopenia induced by chemotherapy in patients with solid tumors: A multicenter, open-label, single-arm trial. Front Pharmacol. 2022 Sep 27;13:970978.

15.Gao Y, Liu Q, Shen Y, et al. Effect of avatrombopag in the management of severe and refractory chemotherapy-induced thrombocytopenia (CIT) in patients with solid tumors. Platelets. 2022 Oct 3;33(7):1024-1030.

16.Kuter DJ, Allen LF. Avatrombopag, an oral thrombopoietin receptor agonist: results of two double-blind, dose-rising, placebo-controlled Phase 1 studies. Br J Haematol. 2018 Nov;183(3):466-478.

17.Jurczak W, Chojnowski K, Mayer J, et al. Phase 3 randomised study of avatrombopag, a novel thrombopoietin receptor agonist for the treatment of chronic immune thrombocytopenia. Br J Haematol. 2018 Nov;183(3):479-490.



作者:歆语健康
Copyright © 2017 上海歆语网络科技有限公司 All rights reserved | 沪ICP备17024312号-1|联系我们
友情链接 歆语健康—上海歆语网络科技有限公司
互联网药品信息服务资格证书编号:(沪)-非经营性-2022-0087
个人信息
个人信息我的关注我的收藏我的动态常见问题反馈建议我的客服分享推广设置