Neurology:化疗导致周围神经病变的RCT的设计特征和报告质量

2017-09-16 吴星 环球医学

2017年8月,发表在《Neurology》的由美国科学家进行的系统评价,考察了化疗导致周围神经病变(CIPN)的临床试验。



2017年8月,发表在《Neurology》的由美国科学家进行的系统评价,考察了化疗导致周围神经病变(CIPN)的临床试验。

目的:评价化疗前或化疗期间,CIPN治疗相关的已发表的随机对照试验(RCTs)的设计特征和报告质量。

方法:在这项针对化疗前或化疗期间CIPN预防或症状性药物治疗的RCTs的系统评价中,通过利用发表于2014年《Journal of Clinical Oncology》的CIPN治疗指南的检索策略,更新PubMed检索结果。

结果:确定了38篇文章。大部分仅纳入接受铂类药物治疗的患者(61%),并使用安慰剂对照(79%)。常见的排除标准为已经存在神经病变(84%)、糖尿病(55%)和接受可能改善神经病变症状的治疗(45%)。95%的研究在CIPN症状出现之前就已经开始试验性治疗。尽管58%的文章确定了一个主要结局测量指标(POM),但仅有32%明确了初步分析。约半数(54%)的POMs为患者报告的症状和功能损害的结局测量指标。其他POMs包括症状的复合测量指标、医师评价指征(23%)和振动试验(14%)。仅有32%的文章呈现过早中断化疗的受试者的数据是如何被分析的,分别有21%和29%的文章报告了由于神经病变或其他/非特定原因而停止化疗的受试者数量。

结论这些数据确定了可以改善的报告实践,用以提升读者严格评价CIPN治疗的RCTs的能力,以及使用这些结果指导未来研究设计和临床实践。提供了报告推荐。

原始出处:

Gewandter JS, et al. Chemotherapy-induced peripheral neuropathy clinical trials: Review and recommendations. Neurology. 2017 Aug 22;89(8):859-869. doi: 10.1212/WNL.0000000000004272. Epub 2017 Jul 26.

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    2017-09-19 传说中的大哥

    学习一下.

    0

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level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sat Sep 16 08:56:12 CST 2017, time=2017-09-16, status=1, ipAttribution=)]
    2017-09-18 meiliwuxian

    学习一下.非常不错

    0

  5. 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    2017-09-17 axin012
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level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sat Sep 16 08:56:12 CST 2017, time=2017-09-16, status=1, ipAttribution=)]
    2017-09-17 wuqianhong99

    学习了.谢谢分享!

    0

  8. 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level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sat Sep 16 08:56:12 CST 2017, time=2017-09-16, status=1, ipAttribution=)]
    2017-09-16 尹玉伟

    厉害厉害--学习了

    0

  9. 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level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sat Sep 16 08:56:12 CST 2017, time=2017-09-16, status=1, ipAttribution=)]
    2017-09-16 等你一年又一年

    学习了.帮助很大

    0

  10. 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level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sat Sep 16 08:56:12 CST 2017, time=2017-09-16, status=1, ipAttribution=)]
    2017-09-16 惠映实验室

    学习了.谢谢.

    0

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周围神经病变在乌干达农村的成年人中比较常见并且与功能性疾病相关。年龄、女性和HIV感染显著增加神经病变的风险

Neurology:糖尿病周围神经病变疼痛与生活质量的药物治疗如何?

由此可见,为了减轻痛苦,度洛西汀和文拉法辛、普瑞巴林和奥卡西平、三环类抗抑郁药、非典型的阿片类药物与A型肉毒毒素比安慰剂更有效。然而,生活质量没有被很好的报道,研究是短期的,药物有大量的停用率,阿片类药物具有显著的风险。未来的研究应评估长期的结局、疼痛管理的使用方法和措施,以及评估患者的生活质量。

JCO:化疗引起的周围神经病变在化疗后对机体功能的影响需关注!

化疗结束后化疗性周围神经病变(Chemotherapy-induced peripheral neuropathy ,CIPN)的持续可能导致机体功能下降。本研究在有或无CIPN症状的女性癌症幸存者间比较了机体功能的客观数据和自我报告数据、步态、跌倒的差异,以确定功能性康复的目标。来自英国的研究人员辅助数据对512名女性癌症幸存者(年龄62±6岁;距离确诊时间,5.8±4.1年)进行了二次分析,研

J Natl Cancer I:让乳腺癌患者动起来:生活方式与紫杉烷诱导的周围神经病变相关!

2017年2月,发表在《J Natl Cancer Inst》的一项由美国科学家进行的研究,得出了生活方式因素与乳腺癌患者紫杉烷诱导的周围神经病变(CIPN)相关的结论。研究人员在通路研究中检测了体重指数(BMI)和生活方式因素与CIPN之间的相关性,该研究是基于浸润性乳腺癌女性的前瞻性队列研究。方法:分析纳入了1237名接受紫杉烷治疗且提供神经毒性症状数据的女性。以基线访谈的形式评估了BMI(正

Heart:周围神经病变与糖尿病患者心血管事件风险增加相关

英国学者们对周围神经病变(PN)与突发心血管事件的关联性以及PN至何种程度可能改善2型糖尿病人群的危险预测进行了探讨。结果表明,PN与糖尿病人群首次心血管事件风险增加具有相关性。相关论文8月5 日在线发表于《心脏》(Heart)杂志。 该研究纳入13 043例无心血管疾病(CVD)的2型糖尿病受试者,记录随访30个月期间的突发CVD事件。确定这些患者基线时心血管危险因素和PN状态,利用Cox回归

Diabetes Care:糖尿病前期是周围神经病变独立高危因素

研究目的:越来越多的证据表明,周围神经病变开始于糖尿病发病的早期阶段。本研究旨在,在存在T2DM发生风险的人群中,根据糖耐量和代谢综合征水平,评估周围神经病变的患病率及与之相关的神经系统的变化。 研究设计与方法:我们选择467名受试者进行纵向的队列研究,评估受试者的新陈代谢水平和胰腺细胞功能。使用密歇根神经病变筛查工具(MNSI)(及其)分数(>2)来定义周围神经病变,同时使用客观的振