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Bisa ga wani gwajin da aka yi a Turai, maganin maye gurbin baƙin ƙarfe na zamani ya haifar da mummunar cutar hypophosphatemia a cikin marasa lafiya tare da anemia da ke hade da cututtukan hanji mai kumburi (IBD), duk da tasiri mai kama da haemoglobin da kantin sayar da ƙarfe.
Heinz Zoller, MD, ya ba da rahoton cewa a cikin binciken PHOSPHARE-IBD ​​na marasa lafiya na 97 IBD tare da ƙarancin ƙarfe anemia wanda aka tsara don ƙarfe carboxymaltose (FCM; Injectafer) tare da demethylmaltose baƙin ƙarfe (FDI; Monoferric).mafi girma a cikin marasa lafiya., Medical University of Innsbruck, Austria, da abokan aiki.
Daga asali zuwa ranar 35, 51% na marasa lafiya na FCM da 8.3% na marasa lafiya na FDI suna da hypophosphatemia a kowane lokaci, kamar yadda aka tabbatar ta hanyar matakan phosphate kasa da 2.0 mg / dL (daidaita bambancin haɗari - 42.8, 95% CI -57.1 zuwa -24.6 )., P<0,0001), - написала группа в Gut. , P<0.0001), ƙungiyar ta rubuta a cikin Gut.
Masu binciken sunyi amfani da allurai iri ɗaya dangane da haemoglobin da nauyin jiki don samfuran duka biyu don yin watsi da yiwuwar rikice-rikice a cikin gwaje-gwajen da suka gabata. Mafi girman abin da ya faru na hypophosphatemia ya faru a cikin makonni 2 na farko na jiko, kuma ya kasance mai girma a cikin ƙungiyar FCM a kwanaki 70 (59.2% vs 12.5%, P<0.0001). Mafi girman abin da ya faru na hypophosphatemia ya faru a cikin makonni 2 na farko na jiko, kuma ya kasance mai girma a cikin ƙungiyar FCM a kwanaki 70 (59.2% vs 12.5%, P<0.0001). Самая высокая частота гипофосфатемии возникла в течение первых 2 недель инфузии и оставалась повышенной в группе FCM через 70 дней (59,2% против 12,5%, P<0,0001). Mafi girman abin da ya faru na hypophosphatemia ya faru a cikin makonni 2 na farko na jiko kuma ya kasance mai girma a cikin ƙungiyar FCM bayan kwanaki 70 (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（ 59.5.0%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（ 59.52% Самая высокая частота гипофосфатемии возникла в течение первых 2 недель инфузии и оставалась повышенной в течение 70 дней в группе FCM (59,2% против 12,5%, P<0,0001). Mafi girman abin da ya faru na hypophosphatemia ya faru a cikin makonni 2 na farko na jiko kuma ya kasance mai girma har tsawon kwanaki 70 a cikin ƙungiyar FCM (59.2% vs 12.5%, P<0.0001).
"Duk da inganci iri ɗaya kuma babu bambance-bambance a cikin halayen rashin lafiyan, shirye-shiryen ƙarfe na zamani guda biyu da aka fi amfani da su a cikin Turai suna da ingantaccen bayanin tsaro, kamar yadda baƙin ƙarfe desmethylmaltose zai iya ɗaukar shiri mafi aminci," Zoller ya gaya wa MedPage A Yau.
Rashin ƙarancin ƙarfe anemia cuta ce ta gama gari na IBD wanda zai iya lalata aikin jiki da fahimi kuma yana ƙara haɗarin asibiti.Kamar yadda aka ambata a baya, FCM da FDI sun nuna kwatankwacin inganci wajen gyara ƙarancin ƙarfe na anemia tare da kusan haɓakar haemoglobin iri ɗaya bayan kwanaki 70 (25.2 da 24.9 g/l, bi da bi).
Bambance-bambance a cikin abin da ya faru na hypophosphatemia tsakanin magungunan maye gurbin baƙin ƙarfe guda biyu da aka lura a baya an yi bayanin su ta wani ɓangare na tsanani ko rashin lafiya na rashin ƙarfi na baƙin ƙarfe, aikin rashin aikin koda na marasa lafiya, da nau'o'in nau'i daban-daban na magungunan ƙwayoyi..Gwajin da aka bazu a baya wanda ya kwatanta magungunan maye gurbin ƙarfe guda biyu, gwajin PHOSPHARE-IDA na Amurka, ya kuma nuna babban abin da ya faru na hypophosphatemia a cikin FCM, ko da yake sashi da jadawalin allurai sun bambanta bisa ga daidaitattun bayanan da aka amince da FDA.
"Binciken na yanzu ya nuna cewa, duk da farfadowa daga hypophosphatemia, yanayin sauye-sauye na sauye-sauye na biochemical da ke hade da babban magana na FGF23 [fibroblast growth factor 23], wanda ake kira "6H ciwo", ya kasance mai zaman kanta ga marasa lafiya da ke karbar FCM, "Zoller.kuma abokan aiki sun rubuta.
"Musamman, takamaiman kashi [alkaline phosphatase] ya kasance mai girma a cikin ƙungiyar FCM idan aka kwatanta da kungiyar FDI a ranar 70, ma'ana cewa FCM ya shafi jujjuya kashi a duk lokacin gwaji da kuma bayan," sun ci gaba."Wannan binciken na iya danganta hypophosphatemia zuwa osteomalacia, haɓakar rikice-rikice na FCM wanda aka jera kwanan nan azaman gargaɗi na musamman a cikin bayanan Turai ga marasa lafiya tare da FCM."
Zoller ya gaya wa MedPage A Yau cewa ƙarin bincike "an mayar da hankali ne kan fahimtar dalilin da yasa magungunan biyu suka bambanta a cikin shigar da FGF23, wani hormone wanda ke haifar da amsa mai rikitarwa da ke haifar da hypophosphatemia, don kauce wa ci gaban ƙwayoyi na gaba."Don samun wannan sakamako na gefe kuma ku fahimci wannan dysregulation. ".”
PHOSPHARE-IBD ​​shine gwajin makafi biyu, bazuwar marasa lafiya na 97 IBD - 61% tare da ulcerative colitis (UC) da 39% tare da cutar Crohn (CD) - a cikin asibitocin Turai 20 tun daga 2018. 2020.
Marasa lafiya masu cancanta suna buƙatar matakin ƙwayar ferritin na 100 ng/mL ko ƙasa, matakin haemoglobin ƙasa da 130 g/L, kuma yana buƙatar ƙarin ƙarfe mai sauri ko kuma yana da rashin haƙuri / rashin hankali, a tsakanin sauran sharuɗɗa.
An ba da izini ga mahalarta a cikin rabo na 1: 1 don karɓar kashi ɗaya na FDI ko FCM dangane da haemoglobin da nauyin jiki a asali da 35 kwanaki daga baya.Ga marasa lafiya da matakan haemoglobin da ke ƙasa da 100 g / l, jimlar adadin shine 1500 MG ga marasa lafiya waɗanda ba su da nauyin kilogiram 70 da 2000 MG ga marasa lafiya masu nauyin kilogiram 70 ko fiye.Marasa lafiya tare da matakin haemoglobin na 100 g/l da sama sun sami jimlar kashi na 1500 MG.
Zoller da abokan aiki sun rubuta: "Idan aka ba da tsarin binciken, ana iya yanke shawarar cewa bambance-bambancen da aka lura a cikin abin da ya faru na hypophosphatemia gaba ɗaya ne saboda bambance-bambance a cikin shirye-shiryen ƙarfe, kuma ba ga jimillar baƙin ƙarfe ba, tsarin dosing, bambance-bambance a CD. idan aka kwatanta da UC.ko wasu abubuwan da ke da alaƙa da haƙuri kamar aikin koda, tsananin kumburi, ƙarancin ƙarancin ƙarfe, ko rashi bitamin D.”
Matsakaicin shekarun marasa lafiya a cikin binciken shine shekaru 42, 53% mata ne, yawancin fararen fata ne (86%), kuma ma'anar ma'aunin jiki shine 27.6.Matsakaicin matakin haemoglobin a tushe shine 105 g/l.
Yawan abubuwan da ba su da kyau (AEs) da abubuwan da suka faru masu tsanani (AEs) sun kasance iri ɗaya don samfurori daban-daban, amma yawancin su sun kasance masu laushi (80-83%).Ƙungiyar FCM ta sami ƙarin ƙarancin bitamin D (35% vs 23%) da ƙarin lokuta na nasopharyngitis (20% vs 17%) fiye da ƙungiyar FDI.A cikin ƙungiyar FDI, ciwon kai (19% vs. 10%) ya fi kowa, kamar yadda tashin zuciya (13% vs. 2%).Ƙarin marasa lafiya a cikin ƙungiyar FDI sun dakatar da magani saboda AEs (6% vs 2%).
Ko da yake duka ayyukan biyu sun haifar da haɓakawa a cikin ma'auni na gajiyar da aka ba da rahoton haƙuri, an ga ci gaba mafi girma da sauri a cikin ƙungiyar FDI, kodayake wannan bambancin ya ɓace bayan kwanaki 70.
Ƙayyadaddun bayanai sun haɗa da ɗan gajeren lokaci mai biyo baya da rashin iyawa don cikakken kimanta sakamakon asibiti.
Zaina Hamza ma'aikaciyar jarida ce ta MedPage A yau ma'aikaciyar ilimin gastroenterology da cututtuka masu yaduwa.Ta kasance a Chicago.
Zoller ya sanar da tallafi daga Abbvie, Bayer, Falk, Gilead, Merz, Medice, Pierre Fabre, Pharmacosmos, Sanofi da Vifor.Marubutan haɗin gwiwar sun ba da rahoton alaƙa da kamfanoni da yawa na magunguna da masana'antu.Marubucin ya kuma bayar da rahoton mawallafin haƙƙin mallaka masu alaƙa da shirye-shiryen ƙarfe na mahaifa.
HANYA ZUWA GA SOURCE: Zoller H et al."Hypophosphatemia bayan gudanar da baƙin ƙarfe desferiomaltose da baƙin ƙarfe carboxymaltose a cikin marasa lafiya tare da raunin baƙin ƙarfe anemia saboda cututtukan ƙwayar cuta (Phosphare-IBD): gwajin gwaji na asibiti" Gut 2022;DOI: 10.1136/gutjnl-2022-327897.
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