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Roxadustat对肾缺血再灌注损伤的保护作用及机制研究
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作者 吴俊波 徐婷 +5 位作者 乔苏迟 韩慧 唐述堂 李晓 陈宇 许新民 《现代生物医学进展》 CAS 2020年第2期214-219,共6页
目的:探讨一种新型PHD抑制剂Roxadustat对小鼠肾缺血再灌注损伤的保护作用及其可能的作用机制。方法:将雄性C57BL/6小鼠随机分为4组:假手术组(sham)、损伤组(IR)、损伤+低剂量给药组(IR+Rox10 mg/kg)以及损伤+高剂量组(IR+Rox25 mg/kg)... 目的:探讨一种新型PHD抑制剂Roxadustat对小鼠肾缺血再灌注损伤的保护作用及其可能的作用机制。方法:将雄性C57BL/6小鼠随机分为4组:假手术组(sham)、损伤组(IR)、损伤+低剂量给药组(IR+Rox10 mg/kg)以及损伤+高剂量组(IR+Rox25 mg/kg)。除假手术组外,其余各组分别于造模前1h、6h、12h给药,并于造模后6h、12h、24h、48h采血检测血肌酐(Scr)、尿素氮(BUN),1d、2d、5d取材肾脏进行病理检测。此外,利用HK-2细胞建立缺氧模型,测定给药后细胞活力和细胞凋亡情况的变化及凋亡通路蛋白和HIF-1α的表达情况。结果:与sham组和IR组相比,给药组Scr和BUN水平均明显降低,且高剂量组Scr和BUN水平显著低于低剂量组,且给药组形态学损伤更轻,细胞凋亡明显减少。细胞学实验显示,Roxadustat能提高低氧条件下HK-2细胞的活力,降低细胞凋亡,并抑制低氧导致的Bax升高,提高Bcl-2的表达,而用HIF-1α抑制剂2-MeOE2,可消除Roxadustat对凋亡的抑制作用。结论:Roxadustat能够通过上调HIF-1α表达,抑制线粒体途径凋亡通路相关蛋白表达,减少细胞凋亡,对小鼠肾脏缺血再灌注损伤产生保护作用。 展开更多
关键词 肾缺血再灌注损伤 roxadustat 细胞凋亡 低氧诱导因子-1Α
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治疗肾性贫血新药--roxadustat 被引量:18
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作者 贺晓瑛 潘兴泉 +1 位作者 李家国 肖典 《临床药物治疗杂志》 2018年第8期1-3,8,共4页
Roxadustat (罗沙司他)是由FibroGen公司开发的一种新型口服低氧诱导因子脯氨酰羟化酶(HIF-PHI)抑制剂,其通过刺激红细胞生成、调节铁代谢发挥疗效。在已完成的临床试验中,roxadustat对透析依赖性慢性肾病(DD-CKD)贫血和非透析依赖性慢... Roxadustat (罗沙司他)是由FibroGen公司开发的一种新型口服低氧诱导因子脯氨酰羟化酶(HIF-PHI)抑制剂,其通过刺激红细胞生成、调节铁代谢发挥疗效。在已完成的临床试验中,roxadustat对透析依赖性慢性肾病(DD-CKD)贫血和非透析依赖性慢性肾病(NDD-CKD)贫血均表现出较好的疗效,且尚未发现增加心血管事件风险。Roxadustat上市申请已于2017年10月提交CFDA,其可能作为全球首个HIF-PH抑制剂在中国率先上市。本文对roxadustat的基本信息、作用机制、药代动力学性质和临床试验情况作一概述。 展开更多
关键词 roxadustat 透析依赖性慢性肾病 非透析依赖性慢性肾病 贫血
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Roxadustat for treatment of erythropoietin-hyporesponsive anemia in a hemodialysis patient:A case report 被引量:6
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作者 Wei-Hong Yu Xie-Jia Li Fang Yuan 《World Journal of Clinical Cases》 SCIE 2020年第23期6048-6055,共8页
BACKGROUND Hyporesponsiveness to erythropoiesis-stimulating agents(ESAs)is a prevalent problem in patients with chronic kidney disease.It is associated with increased morbidity and mortality in patients who undergo di... BACKGROUND Hyporesponsiveness to erythropoiesis-stimulating agents(ESAs)is a prevalent problem in patients with chronic kidney disease.It is associated with increased morbidity and mortality in patients who undergo dialysis.A significant proportion of patients do not respond to iron supplementation and conventional ESAs.We report a case of severe ESA hyporesponsiveness-related anemia that was successfully treated with oral roxadustat.CASE SUMMARY A 59-year-old Chinese woman had high blood glucose for 25 years,maintenance hemodialysis for 7 years,and recurrent dizziness and fatigue for more than 2 years.Laboratory tests showed severe anemia(hemoglobin level of 54 g/L),though bone marrow biopsy,fluorescence in situ hybridization,and hemolysis tests were within normal ranges.We initially administered first-line therapies and other adjuvant treatments,such as blood transfusions,ESAs,and adequate dialysis,but the patient did not respond as anticipated.Her erythropoietinresistant anemia was probably not only due to chronic renal insufficiency.The patient received the hypoxia-inducible factor prolyl hydroxylase inhibitor roxadustat(100 mg,three times weekly).After 12 wk of treatment,the patient’s hemoglobin increased significantly,and her symptoms were alleviated.During the follow-up period,adverse drug reactions were controllable and tolerable.CONCLUSION Oral roxadustat is effective and tolerable for the treatment of ESA hyporesponsiveness-related anemia in patients undergoing hemodialysis. 展开更多
关键词 Renal anemia Erythropoietin hyporesponsiveness HEPCIDIN Interleukin 6 roxadustat Case report
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Roxadustat as treatment for a blood transfusion-dependent maintenance hemodialysis patient:A case report and review of literature 被引量:4
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作者 Min Fei Xiang-Qiong Wen +3 位作者 Zhao-Lan Yu Ting Kang Wei-Hua Wu San-Tao Ou 《World Journal of Clinical Cases》 SCIE 2021年第15期3680-3688,共9页
BACKGROUND Erythropoiesis-stimulating agents(ESAs)have revolutionized the therapeutic strategy for anemia in chronic kidney disease.However,some cases are resistant or hyporesponsive to ESAs.Roxadustat is an oral hypo... BACKGROUND Erythropoiesis-stimulating agents(ESAs)have revolutionized the therapeutic strategy for anemia in chronic kidney disease.However,some cases are resistant or hyporesponsive to ESAs.Roxadustat is an oral hypoxia-inducible factor-prolyl hydroxylase inhibitor that stimulates erythropoiesis and regulates iron metabolism.Here,we describe a hemodialysis patient with refractory anemia who did not respond to traditional treatments and depended on blood transfusion for more than 1 year.After applying Roxadustat,the patient’s anemia improved significantly.CASE SUMMARY A 44-year-old man was diagnosed with uremia accompanied by severe anemia with a hemoglobin(Hb)level ranging from 30-40 g/L.His anemia did not improve after sufficient dialysis or high doses of active ESAs;other causes of anemia were excluded.The patient required approximately 600-1000 mL of red blood cell suspension every 15-30 d for more than 1 year.After accepting Roxadustat therapy,the patient’s anemia symptoms improved significantly;his Hb level gradually increased to 50 g/L,and no further blood transfusions were administered.His Hb level reached 69 g/L by the 34th week.Although a Hb level of 60-70 g/L cannot be considered satisfactory,he no longer required blood transfusions and his quality of life was substantially improved.Roxadustat showed good efficacy and safety in this case.CONCLUSION Roxadustat represents an innovative and effective agent for the clinical treatment of renal anemia caused by multiple complex factors. 展开更多
关键词 Chronic kidney disease Renal anemia Erythropoiesis-stimulating agents Erythropoiesis-stimulating agent resistance roxadustat Case report
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Efficacy of roxadustat in treatment of peritoneal dialysis patients with renal anaemia 被引量:2
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作者 Xin-Wang Zhu Cong-Xiao Zhang +2 位作者 Tian-Hua Xu Guan-Nan Jiang Li Yao 《World Journal of Clinical Cases》 SCIE 2021年第26期7682-7692,共11页
BACKGROUND There are no studies on the use of roxadustat in patients on regular peritoneal dialysis in China.AIM To observe the efficacy and safety of roxadustat in treating renal anaemia in peritoneal dialysis patien... BACKGROUND There are no studies on the use of roxadustat in patients on regular peritoneal dialysis in China.AIM To observe the efficacy and safety of roxadustat in treating renal anaemia in peritoneal dialysis patients.METHODS Patients with renal anaemia who were regularly followed at the Peritoneal Dialysis Center of the First Affiliated Hospital of China Medical University from November 1,2019 to June 30,2020 were selected.A before-and-after self-control design was performed to retrospectively analyse the treatment effects on anaemia in patients treated with recombinant human erythropoietin(EPO)and roxadustat.RESULTS A total of 31 patients with renal anaemia on long-term peritoneal dialysis treated with roxadustat were included.Haemoglobin(Hb)levels were maintained or increased in all patients(100%),and no patients had a decrease in Hb compared with the previous phase.Patients had a mean Hb of 86.2±14.8 g/L with Hb compliance(Hb≥110 g/L)of 16.1%during the EPO phase and a mean Hb of 112.4±18.5 g/L with Hb compliance of 67.7%during the roxadustat phase.No major adverse cardiovascular events occurred in any patient.CONCLUSION The application of roxadustat in peritoneal dialysis patients with renal anaemia can effectively improve the Hb compliance rate. 展开更多
关键词 Peritoneal dialysis Renal anaemia roxadustat HAEMOGLOBIN ERYTHROPOIETIN
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Analysis of the Short-Term Curative Effect of Roxadustat in Treating Renal Anemia in Patients with Peritoneal Dialysis 被引量:1
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作者 Yuechun Cao Jianmin Gao +2 位作者 Qiang Zhu Shuhang Miao Run Tao 《Journal of Clinical and Nursing Research》 2023年第6期145-149,共5页
Objective:To analyze the short-term curative effect of roxadustat in the treatment of renal anemia in patients with peritoneal dialysis.Methods:70 patients with peritoneal dialysis renal anemia admitted to the dialysi... Objective:To analyze the short-term curative effect of roxadustat in the treatment of renal anemia in patients with peritoneal dialysis.Methods:70 patients with peritoneal dialysis renal anemia admitted to the dialysis department of our hospital from March 2021-March 2023 were selected as research objects,divided into a research group and a reference group according to random number drawing method,with each group consisting of 35 cases.The patients in the research group were treated with roxadustat,and those in the reference group were treated with recombinant human erythropoietin.The total efficacy,anemia index,iron metabolism index,and occurrence of adverse reactions were compared between the two groups.Results:The total efficacy of the treatment received in the research group was significantly higher than that in the reference group(P<0.05).In terms of anemia indicators,there was no statistically significant difference between the hemoglobin(Hb),the red blood cell(RBC),and the hematocrit(HCT)of both groups(P>0.05)before treatment.After treatment,the anemia indicators of the patients in the research group were significantly better than those in the reference group,(P<0.05).In terms of iron metabolism,before treatment,there was no significant difference between the total iron-binding capacity(TIBC),the transferrin(TRF),the ferritin(FER),and iron(Fe)of both groups(P>0.05).After treatment,the research group’s iron metabolism indicators were significantly better than those of the reference group(P<0.05).The incidence of adverse reactions in the research group was significantly lower than that in the reference group(P<0.05).Conclusion:The short-term curative effect of roxadustat in the treatment of peritoneal dialysis patients was demonstrated through this study,making it a viable treatment option. 展开更多
关键词 roxadustat Peritoneal dialysis Renal anemia Short-term efficacy
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Roxadustat for treatment of anemia in a cancer patient with endstage renal disease:A case report
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作者 Qiao-Qiao Zhou Jing Li +1 位作者 Bin Liu Chun-Li Wang 《World Journal of Clinical Cases》 SCIE 2022年第19期6587-6594,共8页
BACKGROUNDMost cancer patients are accompanied by anemia, which will be more seriouswhen combined with end-stage renal disease (ESRD). At present, cancer-relatedanemia and renal anemia treatments mainly include erythr... BACKGROUNDMost cancer patients are accompanied by anemia, which will be more seriouswhen combined with end-stage renal disease (ESRD). At present, cancer-relatedanemia and renal anemia treatments mainly include erythropoiesis-stimulatingagents (ESAs), iron supplementation, and blood transfusion, but their effects areoften poor with several safety concerns. We have used roxadustat to treat anemiain a cancer patient with ESRD and achieved a successful outcome for the firsttime.CASE SUMMARYA 64-year-old man was diagnosed with right renal cancer (clear cell renal cellcarcinoma). He did not receive surgery or radiotherapy before admission. He wastreated with oral soltan (sunitinib malate) on April 18, 2017. During oral chemotherapy,he had numerous complications, including anemia, hypertension,thyroid hypofunction, skin pigment loss, and renal function deterioration. At last,he progressed to ESRD and began hemodialysis treatment. We initially treated thepatient with high-dose ESAs, iron supplementation, adequate dialysis, and evenblood transfusion, but his anemia did not improve. Roxadustat is a newlydeveloped drug for renal anemia treatment, but not for cancer-related anemia, letalone to treat anemia in cancer patients with ESRD. We prescribed oral roxadustatto the patient. After a period, his hemoglobin gradually increased. He did nothave obvious discomfort symptoms, and his tumor did not progress significantly.CONCLUSIONOral roxadustat could achieve good results in treating anemia in cancer patients with ESRD. 展开更多
关键词 CANCER End-stage renal disease HEMODIALYSIS ANEMIA roxadustat Case report
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Response to roxadustat in a patient undergoing long-term dialysis and allergic to erythropoiesis-stimulating agents:A case report
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作者 Cai Xu Deng-Gui Luo +6 位作者 Zhe-Yan Liu Dong Yang Dan-Dan Wang Yuan-Zhao Xu Jun Yang Bo Fu Ai-Rong Qi 《World Journal of Clinical Cases》 SCIE 2022年第35期13122-13128,共7页
BACKGROUND Hypoxia-inducible factor prolyl hydroxylase inhibitor is a new class of drugs for treating renal anemia.It is a second-generation hypoxia-inducible factor prolyl hydroxylase-2(PHD2)inhibitor.Roxadustat can ... BACKGROUND Hypoxia-inducible factor prolyl hydroxylase inhibitor is a new class of drugs for treating renal anemia.It is a second-generation hypoxia-inducible factor prolyl hydroxylase-2(PHD2)inhibitor.Roxadustat can effectively increase hemoglobin in patients with dialysis-dependent chronic kidney disease,with an adverse events profile comparable to that of epoetin alfa.We administered roxadustat to a maintenance hemodialysis patient who was allergic to erythropoiesis-stimulating agents(ESAs)and depended on blood transfusion for five years.After applying Roxadustat,the patient’s anemia improved significantly.CASE SUMMARY A 77-year-old Chinese man had type 2 diabetes for 16 years,underwent maintenance hemodialysis for five years,and had fatigue for five years.Laboratory tests showed severe anemia(hemoglobin concentration of 42 g/L).The patient was administered a subcutaneous injection of ESAs before dialysis.He suffered an allergic shock immediately and fainted.His blood pressure dropped to undetectable levels.He was not administered ESAs henceforth.The patient was prescribed iron supplements and received blood transfusions occasionally for five years.His hemoglobin concentration ranged from 42-68 g/L.After taking six weeks of oral roxadustat three times weekly(100 mg TIW),the patient’s hemoglobin concentration increased significantly,and his symptoms decreased.We adjusted the doses of roxadustat,and the hemoglobin concentration was maintained between 97 and 126 g/L.CONCLUSION Oral roxadustat is effective in treating anemia in maintenance hemodialysis patients who cannot be administered ESAs. 展开更多
关键词 Chronic kidney disease HEMODIALYSIS ANEMIA roxadustat Erythropoiesis-stimulating agents Allergic shock Case report
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Observation on the Efficacy of Roxadustat in Treating Low-risk Myelodysplastic Syndrome
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作者 Tao Guo He Li +1 位作者 Hongfang Wang Feng Zhang 《Journal of Clinical and Nursing Research》 2025年第11期263-269,共7页
Objective:To observe the effect of different doses and frequencies of roxadustat on low-risk patients with myelodysplastic syndromes(MDS).Methods:This study was conducted using a comparative treatment observation appr... Objective:To observe the effect of different doses and frequencies of roxadustat on low-risk patients with myelodysplastic syndromes(MDS).Methods:This study was conducted using a comparative treatment observation approach.Low-risk MDS patients admitted to our hospital from February 2022 to February 2023 were selected,excluding patients with a history of severe drug allergies or known allergies to roxadustat.A total of 60 patients were included and randomly divided into observation group A(20 cases,100 mg,twice weekly),observation group B(20 cases,50 mg,once daily),and observation group C(20 cases,150 mg,twice weekly).Patient recovery,adverse reaction rate,and hemoglobin recovery time were compared and statistically analyzed.Results:The recovery rate of group B in the observation group was significantly higher than that in the other two groups,and the incidence of adverse reactions and the time to Hb recovery were also better in group B than in the other two groups(p<0.05).Conclusion:Low-dose,high-frequency(50 mg,once daily)administration can effectively improve the hemoglobin level of low-risk MDS patients and help improve their general survival. 展开更多
关键词 Low-risk MDS roxadustat Anemia
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Long-term safety and effectiveness of roxadustat in Chinese patients with chronic kidney disease-associated anemia:The ROXSTAR registry 被引量:1
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作者 Xiaoying Du Yaomin Wang +13 位作者 Haifeng Yu Jurong Yang Weiming He Zunsong Wang Dongwen Zheng Xiaowei Li Shuijuan Shen Dong Sun Weimin Yu Detian Li Changyun Qian Yiqing Wu Shuting Pan Jianghua Chen 《Chinese Medical Journal》 2025年第12期1465-1476,共12页
Background:Chronic kidney disease(CKD)-associated anemia(CKD-anemia)is associated with poor survival,and hemoglobin targets are often not achieved with current therapies.Phase 3 trials have demonstrated the treatment ... Background:Chronic kidney disease(CKD)-associated anemia(CKD-anemia)is associated with poor survival,and hemoglobin targets are often not achieved with current therapies.Phase 3 trials have demonstrated the treatment efficacy of roxadustat for CKD-anemia.This phase 4 study aims to evaluate the long-term(52-week)safety and effectiveness of roxadustat in a broad real-world patient population with CKD-anemia with and without dialysis in China.Methods:This Phase 4 multicenter,open-label,prospective study,conducted from 24 November 2020 to 11 November 2022,evaluated the long-term safety and effectiveness of roxadustat for CKD-anemia in China.Patients aged≥18 years with CKD-anemia with or without dialysis were included.The initial oral dose was 70-120 mg(weight-based followed by dose adjustment)over 52 weeks.The primary endpoint was safety based on adverse events(AEs).The secondary endpoints were hemoglobin changes from baseline and the proportion of patients who achieved mean hemoglobin≥100 g/L.Effectiveness evaluable populations 1(EE1)and EE2 included roxadustat-naïve and previously roxadustat-treated patients,respectively.The safety analysis set(SAF)included all patients who received≥1 occasion.Results:The EE1,EE2,and SAF populations included 1804,193,and 2021 patients,respectively.In the SAF,the mean age was 50±14 years,and 1087 patients(53.8%)were male.Mean baseline hemoglobin was 96.9±14.0 g/L in EE1 and 100.3±12.9 g/L in EE2.In EE1,the mean(95%confidence interval)hemoglobin changes from baseline over weeks 24-36 and 36-52 were 14.2(13.5-14.9)g/L and 14.3(13.5-15.0)g/L,respectively.Over weeks 24-36 and 36-52,83.3%and 86.1%of patients in EE1 and 82.7%and 84.7%in EE2 achieved mean hemoglobin≥100 g/L,respectively.In the SAF,1643(81.3%)patients experienced treatment-emergent AEs(TEAEs).Overall,219(10.8%)patients experienced drug-related TEAEs.Thirty-eight(1.9%)patients died of TEAEs(unrelated to the study drug).Vascular access thrombosis was uncommon.Conclusions:Roxadustat(52 weeks)increased hemoglobin and maintained the treatment target in Chinese patients with CKD-anemia with acceptable safety,supporting its use in real-world settings. 展开更多
关键词 ANEMIA Chronic kidney disease EFFECTIVENESS roxadustat SAFETY
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低氧诱导因子脯氨酰羟化酶抑制剂roxadustat 被引量:13
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作者 张馨文 刘雯玥 +1 位作者 肖桂芝 孙鹤 《现代药物与临床》 CAS 2016年第4期551-556,共6页
贫血是慢性肾病的重要并发症之一。随着慢性肾病的发展,贫血的发病率也随之不断升高。roxadustat是一种新型的口服低氧诱导因子脯氨酰羟化酶抑制剂,可诱导内源性红细胞生成素升高,无论是尚未接受透析的慢性肾病患者,还是需要透析治疗的... 贫血是慢性肾病的重要并发症之一。随着慢性肾病的发展,贫血的发病率也随之不断升高。roxadustat是一种新型的口服低氧诱导因子脯氨酰羟化酶抑制剂,可诱导内源性红细胞生成素升高,无论是尚未接受透析的慢性肾病患者,还是需要透析治疗的末期肾病患者,roxadustat都能治疗贫血并保持一定的血红蛋白水平,且耐受良好,能够为肾性贫血患者提供更加安全便利的治疗。 展开更多
关键词 roxadustat 低氧诱导因子脯氨酰羟化酶抑制剂 慢性肾病 贫血
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Efficacy and safety of roxadustat in the treatment of refractory non-severe aplastic anemia
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作者 XU Lu 《China Medical Abstracts(Internal Medicine)》 2024年第3期184-184,共1页
Objective To evaluate the efficacy and safety of roxadustat in patients with refractory non-severe aplastic anemia (NSAA).Methods The clinical data of patients with refractory NSAA who had been treated with roxadustat... Objective To evaluate the efficacy and safety of roxadustat in patients with refractory non-severe aplastic anemia (NSAA).Methods The clinical data of patients with refractory NSAA who had been treated with roxadustat continuously for at least 3 months and followed up for more than 6 months at Peking Union Medical College Hospital from October 2020 to August 2022 were retrospectively collected. 展开更多
关键词 ANEMIA APLASTIC roxadustat
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酪酸梭菌联合罗沙司他对血液透析患者肠道菌群失调的改善作用及对微炎症和肠源性毒素的影响
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作者 高永宁 侯晶晶 +1 位作者 王柱 王莉华 《中国微生态学杂志》 北大核心 2025年第6期674-679,685,共7页
目的探讨酪酸梭菌联合罗沙司他对维持性血液透析患者肠道菌群失调的改善作用及对微炎症、肠源性毒素的影响,为该类患者的治疗提供参考。方法选取2024年1月1日至2024年12月31日在河北医科大学第二医院血液透析科门诊治疗的85例血液透析... 目的探讨酪酸梭菌联合罗沙司他对维持性血液透析患者肠道菌群失调的改善作用及对微炎症、肠源性毒素的影响,为该类患者的治疗提供参考。方法选取2024年1月1日至2024年12月31日在河北医科大学第二医院血液透析科门诊治疗的85例血液透析合并肠道菌群失调者为研究对象,随机分为对照组(n=42)和试验组(n=43)。对照组患者给予口服罗沙司他胶囊进行治疗,试验组患者给予酪酸梭菌联合罗沙司他胶囊进行治疗。对比两组患者治疗3个月后的疗效和肠道菌群变化情况。结果治疗3个月后试验组患者Bristol粪便性状评分[(12.98±2.10)分]低于对照组[(17.98±2.10)分],差异有统计学意义(t=-3.180,P<0.05)。试验组患者治疗3个月后Chao1指数(150.36±40.15)、ACE指数(163.09±48.85)、Shannon指数(2.54±0.91)均高于对照组患者,差异均有统计学意义(均P<0.05)。试验组患者治疗3个月后肠道肠球菌属[(6.02±0.65)lg CFU/g]、葡萄球菌属[(5.14±0.58)lg CFU/g]、肠杆菌属[(6.37±0.70)lg CFU/g]数量均低于对照组,差异均有统计学意义(均P<0.05);而乳杆菌属[(8.05±0.93)lg CFU/g]、双歧杆菌属[(9.91±1.23)lg CFU/g]数量、B/E值(1.05±0.34)均高于对照组,差异均有统计学意义(均P<0.05)。试验组患者治疗3个月后血清钙卫蛋白[(9655.00±4927.93)mg/L]、NF-κB[(24.38±4.52)ng/L]、IFN-γ[(39.40±3.99)ng/L]水平均低于对照组患者,差异均有统计学意义(均P<0.05)。治疗3个月后试验组患者血浆DMA[(137.40±30.56)ng/mL]、TMA[(114.56±22.76)ng/mL]、TMAO[(257.53±31.64)ng/mL]水平均低于对照组患者,差异均有统计学意义(均P<0.05)。结论酪酸梭菌联合罗沙司他对血液透析患者肠道菌群失调的改善效果显著,能平衡肠道菌群,改善全身微炎症反应,降低肠源性毒素。 展开更多
关键词 酪酸梭菌 血液透析 肠道菌群失调 罗沙司他 微炎症 肠源性毒素
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不同起始剂量罗沙司他在糖尿病肾病合并肾性贫血患者中的疗效
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作者 张颖 徐燕 +1 位作者 胡淑阳 燕雪 《中国现代医学杂志》 2025年第15期23-30,共8页
目的探讨不同起始剂量罗沙司他在糖尿病肾病合并肾性贫血患者中的治疗效果比较。方法纳入2023年1月—2024年11月中国人民解放军联勤保障部队第904医院治疗的104例糖尿病肾病合并肾性贫血患者,采用信封抽签法随机分为低剂量组(35例)、中... 目的探讨不同起始剂量罗沙司他在糖尿病肾病合并肾性贫血患者中的治疗效果比较。方法纳入2023年1月—2024年11月中国人民解放军联勤保障部队第904医院治疗的104例糖尿病肾病合并肾性贫血患者,采用信封抽签法随机分为低剂量组(35例)、中剂量组(35例)和标准剂量组(34例)。治疗期间根据患者血红蛋白水平进行剂量调整,持续12周。比较治疗前后临床疗效、贫血指标(血红蛋白、红细胞计数、红细胞压积)、肾功能[血肌酐(Scr)、估计肾小球滤过率(eGFR)],铁代谢(血清铁、铁蛋白、总铁结合力、转铁蛋白饱和度)、脂代谢[总胆固醇(TC)、甘油三酯(TG)]、治疗期间的剂量调整及不良反应发生情况。结果3组治疗总有效率比较,差异无统计学意义(P>0.05)。3组治疗前血红蛋白、红细胞计数、红细胞压积、血清铁、铁蛋白、总铁结合力、转铁蛋白饱和度、Scr、eGFR、TC和TG比较,差异均无统计学意义(P>0.05);3组治疗后血红蛋白、红细胞计数、红细胞压积、血清铁、铁蛋白、总铁结合力、转铁蛋白饱和度、Scr、eGFR、TC和TG比较,差异均无统计学意义(P>0.05)。治疗12周后,3组患者血红蛋白、红细胞计数、红细胞压积、血清铁、总铁结合力和转铁蛋白饱和度均较治疗前升高(P<0.05),铁蛋白、TC和TG均较治疗前降低(P<0.05)。标准剂量组中有8例(23.53%)下调剂量,中剂量组中有1例(2.86%)下调剂量,低剂量组中有4例(11.43%)上调剂量。3组患者剂量总调整率、调整量及最终总剂量比较,差异均有统计学意义(P<0.05)。3组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论低剂量和中剂量的罗沙司他均能有效治疗维持性血液透析糖尿病肾病合并肾性贫血,且其疗效与标准剂量组相当,对铁代谢和脂代谢有积极影响。3组治疗效果相近,且治疗过程中未发现明显的剂量相关不良反应,具有较好的耐受性和较少的剂量调整需求。 展开更多
关键词 糖尿病肾病 肾性贫血 罗沙司他 维持性血液透析 起始剂量
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罗沙司他导致低促甲状腺激素性甲状腺功能减退一例
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作者 闫雪莲 唐冰颖 +2 位作者 曲璇 张宁 康琳 《协和医学杂志》 北大核心 2025年第2期519-522,共4页
罗沙司他是全球首个小分子低氧诱导因子脯氨酰羟化酶抑制剂,其引起低促甲状腺激素性甲状腺功能减退的不良反应较为罕见,在多病共存的老年患者中表现隐匿。本文报道1例肾性贫血老年患者,在服用罗沙司他12 d后出现可逆性低促甲状腺激素性... 罗沙司他是全球首个小分子低氧诱导因子脯氨酰羟化酶抑制剂,其引起低促甲状腺激素性甲状腺功能减退的不良反应较为罕见,在多病共存的老年患者中表现隐匿。本文报道1例肾性贫血老年患者,在服用罗沙司他12 d后出现可逆性低促甲状腺激素性甲状腺功能减退,甲状腺激素水平明显下降,停用罗沙司他后15 d,甲状腺激素水平逐渐恢复。后因肾性贫血加重再次服用罗沙司他,9 d后复查甲状腺功能相关指标下降,遂给予左甲状腺素替代治疗。本文结合相关文献对老年慢性肾脏病患者口服罗沙司他过程中发生的不良反应进行分析,旨在为此类患者的药物治疗提供参考。 展开更多
关键词 罗沙司他 缺氧诱导因子脯氨酸羟化酶抑制剂 低促甲状腺激素性甲状腺功能减退
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罗沙司他胶囊联合蔗糖铁注射液治疗维持性血液透析患者肾性贫血的临床效果
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作者 王伟 杨瑞红 《临床医学研究与实践》 2025年第25期82-85,共4页
目的探究罗沙司他胶囊联合蔗糖铁注射液治疗维持性血液透析(MHD)患者肾性贫血的临床效果。方法选取2022年4月至2024年4月在本院进行MHD治疗且并发肾性贫血的82例患者为研究对象,以随机数字表法将其分为对照组和观察组,各41例。对照组在... 目的探究罗沙司他胶囊联合蔗糖铁注射液治疗维持性血液透析(MHD)患者肾性贫血的临床效果。方法选取2022年4月至2024年4月在本院进行MHD治疗且并发肾性贫血的82例患者为研究对象,以随机数字表法将其分为对照组和观察组,各41例。对照组在MHD治疗时同步使用蔗糖铁注射液治疗,观察组在对照组基础上增加罗沙司他胶囊治疗。比较两组的治疗效果。结果治疗后,观察组的血红蛋白(Hb)、红细胞比容(Hct)、红细胞计数(RBC)、血清铁蛋白(SF)及转铁蛋白饱和度(TSAT)均高于对照组(P<0.05)。治疗后,观察组的C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、丙二醛(MDA)及活性氧(ROS)水平均低于对照组(P<0.05)。观察组的治疗显效率及总有效率均高于对照组(P<0.05)。结论罗沙司他胶囊联合蔗糖铁注射液治疗MHD患者肾性贫血的效果显著,能有效增强MHD患者铁储备和利用能力,控制机体炎症和氧化应激反应。 展开更多
关键词 肾性贫血 维持性血液透析 蔗糖铁注射液 罗沙司他胶囊
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罗沙司他与重组人促红素治疗维持性血液透析肾性贫血有效性与经济性评价 被引量:5
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作者 钟婉平 李爱婷 +2 位作者 苏晓燕 苏建伟 王衍洪 《中国药业》 2025年第2期101-105,共5页
目的为临床维持性血液透析(MHD)患者肾性贫血治疗方案的选择提供参考。方法选取医院2020年3月至2022年12月接受MHD的肾性贫血患者111例,根据治疗方案的不同分为重组人促红素(rHuEPO)组(63例)和罗沙司他组(48例)。比较两组患者的铁代谢... 目的为临床维持性血液透析(MHD)患者肾性贫血治疗方案的选择提供参考。方法选取医院2020年3月至2022年12月接受MHD的肾性贫血患者111例,根据治疗方案的不同分为重组人促红素(rHuEPO)组(63例)和罗沙司他组(48例)。比较两组患者的铁代谢指标、贫血指标、血脂指标变化;采用成本-效果分析法进行药物经济性评价,采用单因素敏感性分析经济学评价的可靠性。结果与治疗前比较,罗沙司他组患者治疗后的总铁结合力(TIBC)显著升高,血清铁蛋白(SF)水平显著降低(P<0.05),且TIBC显著高于rHuEPO组(P<0.05)。罗沙司他组患者治疗后的血红蛋白、红细胞计数、红细胞比容较基线的改善情况均显著优于rHuEPO组,且血红蛋白变化值≥10 g/L的比例更高(58.33%比38.10%,P=0.034)。与治疗前比较,罗沙司他组患者治疗后的总胆固醇、低密度脂蛋白胆固醇水平均显著降低(P<0.05),且均显著低于rHuEPO组(P<0.05)。罗沙司他组成本-效果比为464.14,相对于rHuEPO组的增量成本-效果比为519.00(<1倍人均国内生产总值),增加的成本完全值得;敏感性分析结果与之一致。结论与rHuEPO相比,罗沙司他治疗MHD患者肾性贫血的疗效及经济性良好。医师可结合患者支付意愿及疾病进展选择治疗方案。 展开更多
关键词 罗沙司他 重组人促红素 肾性贫血 维持性血液透析 疗效 成本-效果分析
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低氧诱导因子脯氨酰羟化酶抑制剂治疗肾性贫血的临床综合评价 被引量:2
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作者 关丽叶 田冬冬 +2 位作者 吴玉佩 段宝京 方灵芝 《中国医院用药评价与分析》 2025年第4期458-462,共5页
目的:对低氧诱导因子脯氨酰羟化酶抑制剂(HIF-PHI)进行量化评估,以期为不同患者的个体化治疗方案提供参考和依据。方法:根据《中国医疗机构药品评价与遴选快速指南(第二版)》,从药学特性、有效性、安全性、经济性与其他属性5个方面,对两... 目的:对低氧诱导因子脯氨酰羟化酶抑制剂(HIF-PHI)进行量化评估,以期为不同患者的个体化治疗方案提供参考和依据。方法:根据《中国医疗机构药品评价与遴选快速指南(第二版)》,从药学特性、有效性、安全性、经济性与其他属性5个方面,对两种HIF-PHI(恩那度司他、罗沙司他)进行数字化评价。结果:恩那度司他和罗沙司他的得分均>70分,其中恩那度司他片(4 mg)得分最高。恩那度司他目前在国内仅获批用于非透析患者肾性贫血的治疗,且不推荐用于肝功能不全患者;罗沙司他可覆盖上述人群。恩那度司他降低血红蛋白水平的疗效弱于罗沙司他,但降低铁调素水平的疗效优于罗沙司他;建议中、重度贫血的患者选择罗沙司他治疗,对铁剂耐受性差的患者选择恩那度司他治疗。恩那度司他可能更适合需保护残存肾功能的患者;罗沙司他更适合伴有高脂血症的患者。恩那度司他的药物相互作用更少。恩那度司他更具经济性优势。结论:恩那度司他、罗沙司他在不同属性方面各具优势,临床应用中可根据患者人群特点选择药物。 展开更多
关键词 恩那度司他 罗沙司他 药品遴选评价 肾性贫血
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罗沙司他联合重组人促红细胞生成素治疗尿毒症维持性血液透析肾性贫血患者对贫血指标的影响 被引量:1
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作者 蔡震川 张万军 +5 位作者 宋春燕 周豪 何强 陈婷婷 曾文超 漆小明 《实用医院临床杂志》 2025年第4期88-91,共4页
目的分析罗沙司他联合重组人促红细胞生成素(rHuEPO)治疗尿毒症维持性血液透析(MHD)肾性贫血患者对贫血指标的影响。方法2023年3月至2024年3月诊治的96例MHD肾性贫血患者,采用随机数字表法分为罗沙司他组47例和联合组49例,罗沙司他组采... 目的分析罗沙司他联合重组人促红细胞生成素(rHuEPO)治疗尿毒症维持性血液透析(MHD)肾性贫血患者对贫血指标的影响。方法2023年3月至2024年3月诊治的96例MHD肾性贫血患者,采用随机数字表法分为罗沙司他组47例和联合组49例,罗沙司他组采用罗沙司他治疗,联合组采用罗沙司他+rHuEPO治疗。比较治疗后两组临床疗效,治疗前、治疗3个月后,比较两组贫血指标[血红蛋白(Hb)、红细胞压积(HCT)、红细胞计数(RBC)]、铁代谢[铁蛋白(SF)、总铁合力(TIBC)]、炎症因子[可溶性白介素-2受体(SIL-2R)、白介素-6(IL-6)、超敏C反应蛋白(CRP)、肿瘤坏死因子(TNF-α)],并观察治疗期间两组药物不良反应事件。结果联合组治疗总有效率高于罗沙司他组(P<0.05);治疗后,两组Hb、HCT、RBC、SF、TIBC均上升,且联合组高于罗沙司他组(P<0.05);两组SIL-2R、IL-6、CRP及TNF-α水平均下降,且联合组低于罗沙司他组(P<0.05);两组患者药物不良反应总发生率比较差异无统计学意义(P>0.05)。结论罗沙司他联合rHuEPO治疗可明显改善MHD肾性贫血患者的贫血指标,减少炎症反应,且安全性较高。 展开更多
关键词 罗沙司他 重组人促红素 尿毒症维持性血液透析 肾性贫血 炎症反应
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罗沙司他通过活化Nrf2/HO-1信号通路保护腹膜透析患者残余肾功能 被引量:1
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作者 邱杰山 方燊燊 +3 位作者 暨利军 徐志勇 李霞 陈静静 《中国血液净化》 2025年第3期203-207,共5页
目的探讨罗沙司他(roxadustat,Rox)对腹膜透析(peritoneal dialysis,PD)患者残余肾功能(residual renal function,RRF)的干预作用及可能的机制。方法行PD治疗的患者78例,分为红细胞生成素(erythropoiesis stimulating agent,ESA)治疗组(... 目的探讨罗沙司他(roxadustat,Rox)对腹膜透析(peritoneal dialysis,PD)患者残余肾功能(residual renal function,RRF)的干预作用及可能的机制。方法行PD治疗的患者78例,分为红细胞生成素(erythropoiesis stimulating agent,ESA)治疗组(ESA组)和Rox治疗组(Rox组)。检测尿8-羟基脱氧鸟苷酸(8-hydroxydeoxyguanosine,8-OHdG)、β_(2)-微球蛋白(β_(2)-microglobulin,β_(2)-MG)、N乙酰-β氨基葡萄糖苷(N-acetyl-βglucosaminidase,NAG)酶、视黄醇结合蛋白(retinol binding protein,RBP),血单核细胞核因子E2相关因子2(nuclear factor-erythoid2 related factor-2,Nrf2)mRNA及血红素氧合酶1(heme oxygenase-1,HO-1)mRNA。比较治疗后上述指标的差异,将Nrf2 mRNA、HO-1 mRNA表达水平及尿8-OHdG分别与其余指标做相关性分析。结果治疗后,Rox组尿β_(2)-MG、NAG酶、RBP及8-OHdG较治疗前下降(t=3.751、2.522、3.292、3.829,P<0.001、0.014、0.002、<0.001),且低于ESA组(t=3.889、1.627、3.694、2.769,P<0.001、0.035、<0.001、P=0.007),而Nrf2 mRNA及HO1mRNA表达水平较治疗前升高(t=2.797、1.724,P=0.007、0.032),且高于ESA组(t=3.507、2.087,P=0.001、0.040),治疗后ESA组RRF高于ESA组(t=4.710,P<0.001)。Nrf2 mRNA表达水平与尿β_(2)-MG、NAG酶、RBP及8-OHdG呈负相关(r=-0.617、-0.511、-0.598、-0.591,P<0.001、0.001、<0.001、<0.001),与RRF呈正相关(r=0.579,P<0.001)。HO-1 mRNA表达水平与尿β_(2)-MG、RBP及8-OHd呈负相关(r=-0.668、-0.406、0.606,P<0.001、0.013、<0.001),与RRF呈正相关(r=0.532,P=0.001)。尿8-OHdG表达水平与尿β_(2)-MG、NAG酶及RBP表达水平呈正相关(r=0.456、0.453、0.639,P=0.005、0.005、<0.001),与肾小管上皮细胞呈负相关(r=-0.343,P=0.038)。结论Rox可能通过活化Nrf2/HO-1信号通路,抑制氧化应激反应而减轻PD患者肾小管上皮细胞损伤,进而延缓RRF下降。 展开更多
关键词 罗沙司他 腹膜透析 Nrf2/HO-1信号通路 残余肾功能
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