Lancet:有关埃博拉病人的随机对照试验的争议

2014-10-14 佚名 生物谷

2014年10月10日 讯 /生物谷BIOON/ --近日,卫生专家敦促选出一种备用方案用来快速评价出新的埃博拉治疗方法的优劣。在写给《柳叶刀》杂志的资料中显示,来自非洲,欧洲,和美国的17个高级卫生专业人员和医学伦理学家,认为尽管随机对照试验(RCTs)在大多数情况下提供坚实有力的证据,但是针对埃博拉仍缺乏有效的治疗方案。如当前的常规治疗后的高死亡率,在受影响的地区缺乏有效的卫生保健系统意味

2014年10月10日 讯 /生物谷BIOON/ --近日,卫生专家敦促选出一种备用方案用来快速评价出新的埃博拉治疗方法的优劣。在写给《柳叶刀》杂志的资料中显示,来自非洲,欧洲,和美国的17个高级卫生专业人员和医学伦理学家,认为尽管随机对照试验(RCTs)在大多数情况下提供坚实有力的证据,但是针对埃博拉仍缺乏有效的治疗方案。如当前的常规治疗后的高死亡率,在受影响的地区缺乏有效的卫生保健系统意味着备择试验设计需要再考虑。

他们写道,“没有人坚持认同西方医疗工作者提供的zMapp方法和其他只是为了得到药物或常规治疗加安慰剂的随机调查研究。没有人在这种情况下会同意随机实验。在预后不良癌症中没有很好的治疗方法,没有实验对照组的研究证明可以被接受进行充分的部署,甚至在全面分析后科得到监管部门的许可。没有必要为了规则而不能直走捷径:必要的程序已经存在,并且已经在使用。”

“在普通情况下我们接受随机对照试验因为它能产生强有力的证据,但这种情况不适合处于历史上最严重的埃博拉病毒疫情中”他们总结道。“我们迫切需要能够提供生存机会的新的临床实验药物,因此,如果有该种药物的话应由世卫组织推荐使用从而来拯救生命。我们有创新项目但需要试验设计来证明它的实用性。我们应该使用这些创新性药物,而不是固执地坚持黄金标准用来开发不同的设置和目的。”

原始出处:

Clement Adebamowo a, Oumou Bah-Sow b, Fred Binka c, Roberto Bruzzone d, Arthur Caplan e, Jean-François Delfraissy f, David Heymann g, Peter Horby h, Pontiano Kaleebu i, Jean-Jacques Muyembe Tamfum j, Piero Olliaro k lEmail Address, Peter Piot m, Abdul Tejan-Cole n, Oyewale Tomori o, Aissatou Toure p, Els Torreele q, John Whitehead r.Randomised controlled trials for Ebola: practical and ethical issues.The Lancet, Early Online Publication, 13 October 2014.doi:10.1016/S0140-6736(14)61734-7


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    2015-08-18 howi
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    2015-01-12 amyloid
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一名从利比里亚前往美国德克萨斯州达拉斯旅游的男子最近被确诊感染了埃博拉,这是美国本土出现的首例埃博拉患者。目前,该患者病情危重,已被隔离治疗。当地还有一人也出现了疑似埃博拉症状,并被隔离观察。据悉,美国本土第一名埃博拉患者虽病情非常危重,但神志清醒,知道索要食物。在抵达美国前,此人曾在布鲁塞尔专机。目前,第二例出现埃博拉症状的患者病情“严重”。美方正在密切监控与患者有密切接触的人员,其中包括5名儿

13名埃博拉患者服抗艾药拉米夫定获救

美国有线电视新闻网9月27日报道,埃博拉疫情持续肆虐,病人之多已远超医院负荷,感染人数仍在不断攀升,援助和疫苗也迟迟不见踪影,绝望之中,利比里亚一医生“兵行险着”,启用抗HIV药物进行治疗,不料竟获奇效。在杜伯曼堡的一家隔离中心,医生洛根让诊所内的埃博拉感染者服用了治疗艾滋病的药物拉米夫定,结果15人中13人生还,死亡率从原来的70%下降至7%。据了解,生还病人在感染后的5天内服用了拉米夫定。