Kolhicīna off-label lietošana kardioloģijā.
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Date
2021
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Kolhicīns kā pretiekaisuma līdzeklis ir pierādījis savu efektivitāti tādu reģistrētu indikāciju terapijā kā podagra, brucelloze un Behčeta slimība. Tas ir pētīts kardioloģijā dažādu saslimšanu gadījumā – akūts koronārs sindroms, perikardīts, ātriju fibrillācija, koronāro artēriju slimība, postperikardiotomijas sindroms, postoperatīva perikardiāla efūzija un postoperatīva pleirāla efūzija, kam kolhicīna terapija ir off-label, un nav pietiekami daudz pētījumu par kolhicīna lietošanu off-label.
Pētījuma mērķis ir izpētīt kolhicīna off-label lietošanu dažādām kardioloģiskām saslimšanām randomizētos kontrolētos pētījumos, kuros primārie galamērķi ir klīniski nozīmīgi rādītāji un kuri ir savstarpēji salīdzināmi saslimšanu ietvaros. Pētnieciskais darbs ir literatūras apskats, kas veikts, izmantojot PRISMA Scoping review metodiku. Apskatā ir analizēti randomizēti kontrolēti pētījumi, kas ir publicēti, sākot no 2005. gada. Pētījuma rezultātā pēc meklēšanas rezultātu atlases tika analizēti 13 randomizēti kontrolēti pētījumi saslimšanu grupu ietvaros ar klīniski nozīmīgiem primārajiem galamērķiem. Akūta perikardīta gadījumā kolhicīna terapijas ietekme novērojama divos no trim pētījumiem. Individuālos postoperatīvas ātriju fibrillācijas pētījumos tiek novērota kolhicīna terapijas ietekme, bet savstarpēji rezultāti nav salīdzināmi atšķirīgo apsekošanas laiku dēļ. Rekurenta perikardīta pētījumos novēro kolhicīna terapijas ietekmi, bet tiem ir viens galvenais autors. Postoperatīvas perikardiālas, pleirālas efūzijas un postperikardiotomijas sindroma pētījumu rezultātus nevar salīdzināt atšķirīgās metodikas dēļ. Pēc primārajiem galamērķiem postoperatīvas ātriju fibrillācijas un rekurenta perikardīta pētījumos novēro slimības gaitas uzlabošanos, bet akūta perikardīta un postoperatīvas perikardiālas, pleirālas efūzijas un postperikardiotomijas sindroma pētījumu rezultāti nav viennozīmīgi, jo atšķīrās pētījumu protokoli. Kolhicīna terapijā netiek novērotas dzīvību apdraudošas un smagas blakusparādības. Ļoti bieži (≥1/10) un bieži (≥1/100 to <1/10) tika novērotas kuņģa-zarnu trakta blakusparādības.
Pētnieciskā darba apjoms ir 49 lapas, izmantoti 52 informācijas avoti, satur 16 attēlus, 8 tabulas un 10 pielikumus.
Off-Label Use of Colchicine in Cardiology Colchicine as an anti-inflammatory agent has been shown to be effective in the treatment of registered indications such as gout, brucellosis and Behcet's disease. It has been studied in cardiology for a variety of conditions - acute coronary syndrome, pericarditis, atrial fibrillation, coronary artery disease, postpericardiotomy syndrome, postoperative pericardial effusion and postoperative pleural effusion for which colchicine therapy is off-label use and there are not enough studies about colchicine off-label use. The aim of the study was to investigate off-label use of colchicine for various cardiological diseases in randomized controlled trials with clinically relevant primary endpoints and trials are comparable between diseases. The research work is a literature review performed using the PRISMA Scoping review methodology. The review analyzes randomized controlled trials published since 2005. As a result of the study, 13 randomized controlled trials within disease groups with clinically relevant primary endpoints were analyzed after selection of search results. In acute pericarditis, the efficacy of colchicine treatment was seen in two of the three studies. In individual postoperative atrial fibrillation studies, the effects of colchicine treatment have been observed, but the results are not comparable due to different observation times. Recurrent pericarditis studies have observed the efficacy of colchicine therapy but have one principal researcher. The results of postoperative pericardial, pleural effusion and postpericardiotomy syndrome studies cannot be compared due to different methodologies. Post-operative atrial fibrillation and recurrent pericarditis have been shown to reduce disease progression by primary endpoints, but acute pericarditis and postoperative pericardial, pleural effusion, and postpericardiotomy syndrome were inconclusive due to differences in study protocols. No life-threatening or severe side effects have been observed with colchicine therapy. Gastrointestinal adverse reactions were very common (≥1 / 10) and common (≥1 / 100 to <1/10). The volume of the research work is 49 pages, 52 sources of information are used, it contains 16 figures, 8 tables and 10 appendices.
Off-Label Use of Colchicine in Cardiology Colchicine as an anti-inflammatory agent has been shown to be effective in the treatment of registered indications such as gout, brucellosis and Behcet's disease. It has been studied in cardiology for a variety of conditions - acute coronary syndrome, pericarditis, atrial fibrillation, coronary artery disease, postpericardiotomy syndrome, postoperative pericardial effusion and postoperative pleural effusion for which colchicine therapy is off-label use and there are not enough studies about colchicine off-label use. The aim of the study was to investigate off-label use of colchicine for various cardiological diseases in randomized controlled trials with clinically relevant primary endpoints and trials are comparable between diseases. The research work is a literature review performed using the PRISMA Scoping review methodology. The review analyzes randomized controlled trials published since 2005. As a result of the study, 13 randomized controlled trials within disease groups with clinically relevant primary endpoints were analyzed after selection of search results. In acute pericarditis, the efficacy of colchicine treatment was seen in two of the three studies. In individual postoperative atrial fibrillation studies, the effects of colchicine treatment have been observed, but the results are not comparable due to different observation times. Recurrent pericarditis studies have observed the efficacy of colchicine therapy but have one principal researcher. The results of postoperative pericardial, pleural effusion and postpericardiotomy syndrome studies cannot be compared due to different methodologies. Post-operative atrial fibrillation and recurrent pericarditis have been shown to reduce disease progression by primary endpoints, but acute pericarditis and postoperative pericardial, pleural effusion, and postpericardiotomy syndrome were inconclusive due to differences in study protocols. No life-threatening or severe side effects have been observed with colchicine therapy. Gastrointestinal adverse reactions were very common (≥1 / 10) and common (≥1 / 100 to <1/10). The volume of the research work is 49 pages, 52 sources of information are used, it contains 16 figures, 8 tables and 10 appendices.
Description
Farmācija
Pharmacy
Veselības aprūpe
Health Care
Pharmacy
Veselības aprūpe
Health Care
Keywords
kolhicīns, off-label, akūts perikardīts, postoperatīva ātriju fibrillācija, rekurents perikardīts, postoperatīva perikardiāla efūzija, postoperatīva pleirāla efūzija, postperikardiotomijas sindroms., colchicine, off-label, acute pericarditis, postoperative atrial fibrillation, recurrent pericarditis, postoperative pericardial effusion, postoperative pleural effusion, postpericardiotomy syndrome.