JACC:IL-6R抑制剂托珠单抗可有效改善急性STEMI患者的心肌挽救

2021-04-23 MedSci原创 MedSci原创

托珠单抗可以改善急性STEMI患者的心肌挽救~

经皮冠状动脉介入治疗(PCI)可迅速进行心肌血运重建,进而减少ST段抬高型心肌梗死(STEMI)患者的梗死心肌面积,从而改善其临床预后。但是,多达50%的失用心肌可能得归因于再灌注损伤和相关的炎症反应。

本研究旨在评估白细胞介素-6受体抑制剂托珠单抗(tocilizumab)用于急性STEMI时挽救心肌活性的作用

ASSAIL-MI试验是一项在挪威的3家大体量PCI中心开展的随机、双盲、安慰剂为对照的临床研究。纳入了在症状发作后6小时内确诊为STEMI的患者。受试患者被1:1随机分至两组,单次输注280 mg 托珠单抗或安慰剂。主要终点是3-7天后通过心脏磁共振检测的心肌挽救指数。

研究设计及主要研究结果

总体上,共招募了199位患者,其中101位被分至托珠单抗组,98位被分至安慰剂组。托珠单抗组患者的心肌挽救指数明显高于对照组(校正组间差异 5.6,95% CI 0.2-11.3;p=0.04)。托珠单抗组患者的微血管阻塞程度较轻,但托珠单抗组和安慰剂组的最终梗死面积无显著差异(7.2% vs 9.1%;p=0.08)。两组间的不良反应也无明显差异。

综上所述,托珠单抗可以改善急性STEMI患者的心肌挽救

原始出处:

Broch Kaspar,Anstensrud Anne Kristine,Woxholt Sindre et al. Randomized Trial of Interleukin-6 Receptor Inhibition in Patients With Acute ST-Segment Elevation Myocardial Infarction. J Am Coll Cardiol, 2021, 77: 1845-1855. https://doi.org/10.1016/j.jacc.2021.02.049

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    2021-08-01 jklm09
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    2021-11-21 hbwxf
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    2021-04-25 kzlchina
  5. [GetPortalCommentsPageByObjectIdResponse(id=1936742, encodeId=c8f91936e4268, content=<a href='/topic/show?id=74bd16e850c' target=_blank style='color:#2F92EE;'>#STEMI患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16785, encryptionId=74bd16e850c, topicName=STEMI患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, createdName=12498c32m68暂无昵称, createdTime=Thu Apr 29 22:16:20 CST 2021, time=2021-04-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1852637, encodeId=597d185263e10, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sun Aug 01 05:16:20 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854920, encodeId=9f2518549205e, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sun Nov 21 14:16:20 CST 2021, time=2021-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1273803, encodeId=e0ba12e3803f0, content=<a href='/topic/show?id=fae896e7ea' target=_blank style='color:#2F92EE;'>#IL-6#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9677, encryptionId=fae896e7ea, topicName=IL-6)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f984116, createdName=kzlchina, createdTime=Sun Apr 25 05:16:20 CST 2021, time=2021-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326777, encodeId=0fcc1326e7790, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sun Apr 25 05:16:20 CST 2021, time=2021-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349854, encodeId=6a24134985414, content=<a href='/topic/show?id=6c5796e898' target=_blank style='color:#2F92EE;'>#IL-6R#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9678, encryptionId=6c5796e898, topicName=IL-6R)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sun Apr 25 05:16:20 CST 2021, time=2021-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1482324, encodeId=7ab1148232486, content=<a href='/topic/show?id=8cc416e78f3' target=_blank style='color:#2F92EE;'>#STEM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16778, encryptionId=8cc416e78f3, topicName=STEM)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d1067833268, createdName=12498bb3m92(暂无昵称), createdTime=Sun Apr 25 05:16:20 CST 2021, time=2021-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959855, encodeId=ea3095985530, content=积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b7405485527, createdName=飞到城市那一边, createdTime=Fri Apr 23 18:47:45 CST 2021, time=2021-04-23, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1936742, encodeId=c8f91936e4268, content=<a href='/topic/show?id=74bd16e850c' target=_blank style='color:#2F92EE;'>#STEMI患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16785, encryptionId=74bd16e850c, topicName=STEMI患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, createdName=12498c32m68暂无昵称, createdTime=Thu Apr 29 22:16:20 CST 2021, time=2021-04-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1852637, encodeId=597d185263e10, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sun Aug 01 05:16:20 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854920, encodeId=9f2518549205e, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sun Nov 21 14:16:20 CST 2021, time=2021-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1273803, encodeId=e0ba12e3803f0, content=<a href='/topic/show?id=fae896e7ea' target=_blank style='color:#2F92EE;'>#IL-6#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9677, encryptionId=fae896e7ea, topicName=IL-6)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f984116, createdName=kzlchina, createdTime=Sun Apr 25 05:16:20 CST 2021, time=2021-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326777, encodeId=0fcc1326e7790, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sun Apr 25 05:16:20 CST 2021, time=2021-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349854, encodeId=6a24134985414, content=<a href='/topic/show?id=6c5796e898' target=_blank style='color:#2F92EE;'>#IL-6R#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9678, encryptionId=6c5796e898, topicName=IL-6R)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sun Apr 25 05:16:20 CST 2021, time=2021-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1482324, encodeId=7ab1148232486, content=<a href='/topic/show?id=8cc416e78f3' target=_blank style='color:#2F92EE;'>#STEM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16778, encryptionId=8cc416e78f3, topicName=STEM)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d1067833268, createdName=12498bb3m92(暂无昵称), createdTime=Sun Apr 25 05:16:20 CST 2021, time=2021-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959855, encodeId=ea3095985530, content=积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b7405485527, createdName=飞到城市那一边, createdTime=Fri Apr 23 18:47:45 CST 2021, time=2021-04-23, status=1, ipAttribution=)]
    2021-04-25 jklm09
  7. [GetPortalCommentsPageByObjectIdResponse(id=1936742, encodeId=c8f91936e4268, content=<a href='/topic/show?id=74bd16e850c' target=_blank style='color:#2F92EE;'>#STEMI患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16785, encryptionId=74bd16e850c, topicName=STEMI患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, createdName=12498c32m68暂无昵称, createdTime=Thu Apr 29 22:16:20 CST 2021, time=2021-04-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1852637, encodeId=597d185263e10, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sun Aug 01 05:16:20 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854920, encodeId=9f2518549205e, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sun Nov 21 14:16:20 CST 2021, time=2021-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1273803, encodeId=e0ba12e3803f0, content=<a href='/topic/show?id=fae896e7ea' target=_blank style='color:#2F92EE;'>#IL-6#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9677, encryptionId=fae896e7ea, topicName=IL-6)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f984116, createdName=kzlchina, createdTime=Sun Apr 25 05:16:20 CST 2021, time=2021-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326777, encodeId=0fcc1326e7790, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sun Apr 25 05:16:20 CST 2021, time=2021-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349854, encodeId=6a24134985414, content=<a href='/topic/show?id=6c5796e898' target=_blank style='color:#2F92EE;'>#IL-6R#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9678, encryptionId=6c5796e898, topicName=IL-6R)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sun Apr 25 05:16:20 CST 2021, time=2021-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1482324, encodeId=7ab1148232486, content=<a href='/topic/show?id=8cc416e78f3' target=_blank style='color:#2F92EE;'>#STEM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16778, encryptionId=8cc416e78f3, topicName=STEM)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d1067833268, createdName=12498bb3m92(暂无昵称), createdTime=Sun Apr 25 05:16:20 CST 2021, time=2021-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959855, encodeId=ea3095985530, content=积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b7405485527, createdName=飞到城市那一边, createdTime=Fri Apr 23 18:47:45 CST 2021, time=2021-04-23, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1936742, encodeId=c8f91936e4268, content=<a href='/topic/show?id=74bd16e850c' target=_blank style='color:#2F92EE;'>#STEMI患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16785, encryptionId=74bd16e850c, topicName=STEMI患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, createdName=12498c32m68暂无昵称, createdTime=Thu Apr 29 22:16:20 CST 2021, time=2021-04-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1852637, encodeId=597d185263e10, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sun Aug 01 05:16:20 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854920, encodeId=9f2518549205e, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sun Nov 21 14:16:20 CST 2021, time=2021-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1273803, encodeId=e0ba12e3803f0, content=<a href='/topic/show?id=fae896e7ea' target=_blank style='color:#2F92EE;'>#IL-6#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9677, encryptionId=fae896e7ea, topicName=IL-6)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f984116, createdName=kzlchina, createdTime=Sun Apr 25 05:16:20 CST 2021, time=2021-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326777, encodeId=0fcc1326e7790, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sun Apr 25 05:16:20 CST 2021, time=2021-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349854, encodeId=6a24134985414, content=<a href='/topic/show?id=6c5796e898' target=_blank style='color:#2F92EE;'>#IL-6R#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9678, encryptionId=6c5796e898, topicName=IL-6R)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sun Apr 25 05:16:20 CST 2021, time=2021-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1482324, encodeId=7ab1148232486, content=<a href='/topic/show?id=8cc416e78f3' target=_blank style='color:#2F92EE;'>#STEM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16778, encryptionId=8cc416e78f3, topicName=STEM)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d1067833268, createdName=12498bb3m92(暂无昵称), createdTime=Sun Apr 25 05:16:20 CST 2021, time=2021-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959855, encodeId=ea3095985530, content=积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b7405485527, createdName=飞到城市那一边, createdTime=Fri Apr 23 18:47:45 CST 2021, time=2021-04-23, status=1, ipAttribution=)]
    2021-04-23 飞到城市那一边

    积分

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J Transl Med:托珠单抗治疗COVID-19的有效性和安全性分析

托珠单抗可阻断白细胞介素-6(IL-6)的促炎活性,IL-6与肺炎的发生有关,而肺炎是COVID-19患者最常见的死亡原因。一项多中心、单臂、假设驱动的试验探究了托珠单抗治疗COVID-19的有效性和

NEJM:托珠单抗用于新冠肺炎住院患者的治疗

对于未进行机械通气的新冠肺炎住院患者,在标准护理基础上添加托珠单抗可降低患者机械通气或死亡风险,但对改善患者生存率无显著帮助

Lancet Neurology:托珠单抗与硫唑嘌呤治疗高度复发性视神经脊髓炎频谱障碍(TANGO)的安全性和有效性:一项开放性、多中心、随机、2期试验

视神经脊髓炎(NMOSD)是一种严重的中枢神经系统致残性炎症性自身免疫性疾病,常伴有水通道蛋白-4(AQP-4)的病理性体液免疫反应。这种疾病最常见的特征是反复复发的视神经炎和纵向广泛的横向脊髓炎。

托珠单抗中国获批用于治疗CAR-T疗法引起的细胞因子风暴

日前,罗氏托珠单抗注射液(商品名:雅美罗)获得国家药监局批准,用于成年和2岁及以上儿童患者由嵌合抗原受体(CAR)T细胞引起的重度或危及生命的细胞因子释放综合征(CRS)。

EClinicalMedicine:托珠单抗治疗会增加COVID-19重症患者死亡风险

自2020年3月以来,COVID-19疫情对西班牙卫生系统带来了挑战。一些可用疗法(抗疟药物、抗病毒药物、生物制剂)均是基于临床病例观察或基础科学数据。本研究目的是表征COVID-19重症患者的特点和

BMJ:托珠单抗治疗对重症及危重新冠肺炎患者临床改善作用不明显

在重症或危重covid-19患者中,在标准治疗方案基础上添加托珠单抗不能改善患者15天临床结果,并且可能与死亡率增加有关