治疗模式和与单克隆抗体停用相关的因素。
Treatment patterns and factors associated with discontinuation of monoclonal antibodies.
发表日期:2024
作者:
Muzoon Matar Saleh Alkaabi, Syed Arman Rabbani, Padma Gm Rao, Mai Ismail Mohamedelhassan
来源:
CLINICAL PHARMACOLOGY & THERAPEUTICS
摘要:
生物制剂彻底改变了肿瘤学、免疫学、传染病和遗传性疾病等专业的护理,对特定分子或选定的免疫细胞提供有针对性的作用。单克隆抗体以其高特异性和精确度而闻名,是这些药物中最重要且快速扩展的类别之一。了解单克隆抗体的药物利用模式对于确保其最佳使用至关重要,特别是考虑到其高成本和潜在的副作用。这项分析性横断面研究是在阿拉伯联合酋长国的一家二级医院进行的。包括在研究地点接受单克隆抗体的任一性别的患者。对治疗模式、使用情况以及与单克隆抗体停用相关的因素进行了评估。高脂血症 (136, 39.1%) 是单克隆抗体最常见的适应症,其次是预防先天性心脏病中的呼吸道合胞病毒感染 (104, 29.9%) )和骨质疏松症(42,12.1%)。 Evolocumab 是最常用的单克隆抗体(135 例,38.8%),其次是帕利珠单抗(104 例,29.9%)和 dupilumab(38 例,10.9%)。大多数单克隆抗体的规定日剂量与规定日剂量之比为 1.0,反映了它们的适当利用。 129 名患者 (37.0%) 在研究期间停止了治疗。患95% CI: 1.202-5.025, p = 0.014) 和治疗持续时间 (OR: 9.180, 95% CI: 4.909-17.165, p < 0.001) 被确定为停止单克隆抗体的预测因素。这项研究代表了第一项全面调查阿拉伯联合酋长国的研究重点是当地人群中单克隆抗体的治疗模式、利用和停用。单克隆抗体用于治疗多种临床病症。该研究报告了大多数单克隆抗体的适当利用,并确定了患者教育水平、BMI、合并用药和治疗持续时间等因素作为单克隆抗体治疗中断的独立预测因素。© 作者 2024。
Biological agents have revolutionized care in specialties such as oncology, immunology, infectious diseases, and genetic disorders, offering targeted actions on specific molecules or select immune cells. Monoclonal antibodies, known for their high specificity and precision, represent one of the most significant and rapidly expanding categories of these agents. Understanding the drug utilization patterns of monoclonal antibodies is crucial to ensure their optimal use, especially given their high cost and potential adverse effects.This analytical cross-sectional study was conducted in a secondary hospital in the United Arab Emirates. Patients of either gender receiving monoclonal antibodies at the study site were included. Treatment patterns, utilization, and factors associated with the discontinuation of monoclonal antibodies were assessed.Hyperlipidemia (136, 39.1%) was the most common indication for monoclonal antibodies, followed by prophylaxis of respiratory syncytial virus infection in congenital heart disease (104, 29.9%) and osteoporosis (42, 12.1%). Evolocumab was the most commonly prescribed monoclonal antibody (135, 38.8%), followed by palivizumab (104, 29.9%), and dupilumab (38, 10.9%). The majority of monoclonal antibodies demonstrated a prescribed daily dose to defined daily dose ratio of 1.0, reflecting their appropriate utilization. One hundred twenty-nine patients (37.0%) discontinued their treatment during the study. Patient's level of education (OR: 0.416, 95% CI: 0.183-0.943, p = 0.036), BMI (OR: 2.358, 95% CI: 1.164-4.777, p = 0.017), number of concomitant medications (OR: 2.457, 95% CI: 1.202-5.025, p = 0.014), and treatment duration (OR: 9.180, 95% CI: 4.909-17.165, p < 0.001) were identified as predictors of discontinuation of monoclonal antibodies.This study represents the first comprehensive investigation in the United Arab Emirates focused on treatment patterns, utilization, and discontinuation of monoclonal antibodies among the local population. Monoclonal antibodies were prescribed for the management of a wide range of clinical conditions. The study reports appropriate utilization of most monoclonal antibodies and identifies factors such as patient education level, BMI, concomitant medications, and treatment duration as independent predictors of monoclonal antibody treatment discontinuation.© The Author(s) 2024.