Down syndrome (DS) is the most common chromosomal disorder; with the increasing life expectancy, about 80% of DS adults reach age 65 years old. Early Alzheimer's disease (AD) is the most common cause of death within this population. DS individuals already show AD neuropathology by the age of 30, while it becomes clinically recognized in their late forties. DS subjects also exhibit olfaction defects in adulthood.
To date, there is no treatment available for the cognitive or olfactory defects in DS. The development of an effective treatment targeting cognitive dysfunction in DS adolescents/adults would be warranted.
GnRH, a decapeptide secreted by hypothalamic neurons is the pilot light of reproduction in all mammals. Pulsatile GnRH acts on the gonadotrophs via the GnRH receptor (GNRHR) in the pituitary gland to stimulate LH and FSH, which themselves will act on the gonads to produce gametes and steroids. However, GNRHR are also expressed in cerebral cortex, hippocampus, amygdala, habenula, olfactory structures, and adrenal gland, suggesting that GnRH may have a role beyond reproduction.
Recently, GnRH has been shown to be involved in the process of ageing and lifespan control. Notably, in murine models, GnRH acts as an anti-ageing factor, independent of sex hormones. While ageing is characterized by hypothalamic inflammation and diminished neurogenesis, particularly in the hypothalamus and the hippocampus, GnRH was able to promote adult neurogenesis.
The regulation of GnRH secretion is complex and involves hormonal, neuronal input, and environmental factors.
Prévot et al. recently explored cognition within the Ts65Dn model and showed an age-dependent loss of the ability to recognize new objects. Also, these mice exhibit defects in olfaction. Given the role of GnRH in anti-aging mice model, pulsatile GnRH or continuous GnRH infusion (leading to desensitization of the GNRHR) were given to the Ts65Dn mice for two weeks. Amazingly, pulsatile but not continuous GnRH therapy was able to recover cognitive and olfaction defects.

开始日期2020-08-27

申办/合作机构

Centre Hospitalier Universitaire Vaudois

NCT04037605 / Active, not recruiting早期临床1期IIT

Hormonal Mechanisms of Sleep Restriction - Axis Study in Older Men and Postmenopausal Women

The purpose of this study is to 1) determine how hypothalamic-pituitary-adrenal axis (HPA axis) activation occurs with sleep restriction and 2) evaluate how hypothalamic-pituitary-gonadal axis (HPG axis) deactivation occurs with sleep restriction. The investigator will also examine the cognitive function associated with sleep restriction, including food intake and food cravings.

开始日期2020-02-09

申办/合作机构

The Lundquist Institute

NCT02588404 / Not yet recruitingN/AIIT

The Predictive Value of TMPRSS2-ERG Fusion in High Risk Prostate Cancer Patient

The objective of this study is to evaluate the predictive value of TMPRSS2-ERG gene fusion in patients with prostate cancer treated with radiation and hormonal therapy.

开始日期2016-12-01

申办/合作机构

The Jewish General Hospital

100 项与醋酸戈那瑞林相关的临床结果

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100 项与醋酸戈那瑞林相关的转化医学

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100 项与醋酸戈那瑞林相关的专利（医药）

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项与醋酸戈那瑞林相关的文献（医药）

2024-08-01·THERIOGENOLOGY

Impact of 17β-estradiol administration at the moment of timed-AI in Nelore cows with small dominant follicle or not showing estrus

Article

作者: Marques, Hugo Savioli ; Guimarães Peres, Rogério Fonseca ; Feltrin, Isabella Rio ; Bonacim, Paulo Mielli ; Guimarães da Silva, Amanda ; Degan Mattos, Ana Clara ; Poit, Diego Angelo Schmidt ; Pugliesi, Guilherme ; Neto, Adomar Laurindo ; Bisinotto, Danilo Zago

We aimed to evaluate the effects of administering estradiol (E-17β) at the moment of timed-AI (TAI) on uterine gene expression, estrous expression rate (EER), and pregnancy rate (P/TAI) in Nelore cows with a small dominant follicle (DF) or not showing estrus at TAI. In Experiments 1 and 2 (Exp1, Exp2) cows were submitted to a P4/E-17β-based protocol (day 0) for synchronization of ovulation. On day 7, devices were removed, cows received 1 mg E-17β cypionate and 12.5 mg dinoprost. On day 9, cows with DF < 11.5 mm in diameter were split into different groups. In Exp1 (n = 16/group): Control (no treatment), E-2 (2 mg E-17β) and E-4 (4 mg E-17β). In Exp2: Control (n = 12); E-2 (n = 14); GnRH (0.1 mg gonadorelin acetate, n = 13); and E-2+GnRH (association of GnRH and E-17β, n = 13). Between days 9 and 11, endometrial thickness (ET), time of ovulation detection, and EER were recorded. In Exp1, a uterine cytological sample was collected 4 h after treatment to evaluate the transcript expression of receptors for E-17β (ESR1 and ESR2), oxytocin (OXTR), and P4 (PGR). In Experiment 3 (Exp3), 3829 suckled cows were submitted to a P4/E-17β-based protocol for TAI. On day 9, devices were removed and cows received 1 mg E-17β cypionate and 0.4 mg sodium cloprostenol. On day 11, TAI was performed and cows that did not demonstrate estrus received 0.1 mg gonadorelin acetate, and were allocated into two groups: GnRH (n = 368) and E-2+GnRH (2 mg E-17β; n = 363). In Exp1, plasma E-17β concentrations increased at 4 h after treatment in a dose-dependent manner but reduced at 12 h. The E-17β-treated cows had greater transcript abundance for OXTR and lesser for ESR1 and ESR2, and the ET was reduced 12 h after treatment (P < 0.05). No significant difference (P > 0.1) was observed between the E-17β doses in estrus or ovulation rate. In Exp2, the interval from treatment to ovulation was longer (P < 0.05) in the E-17β group. GnRH-treated cows showed higher ovulation rates (89 vs. 35 %) compared to cows not treated with GnRH, as E-17β-treated cows (P < 0.01) had a lower ovulation rate compared to those not receiving E-17β (44 vs. 78 %). In Exp3, P/TAI was 55 % for cows in estrus. For those not showing estrus, no difference (P > 0.1) in P/TAI was observed between GnRH (34 %) and E-2+GnRH (31 %) groups. Cows with a DF ≥ 11 mm (n = 192) had a greater (P < 0.05) P/TAI (49 %) than those with DF < 11 mm (n = 377; 29 %). In conclusion, E-17β administration in the moment of TAI modulates the mRNA expression of uterine receptors in cows with a small DF but does not impact the P/TAI compared with GnRH treatment in suckled Nelore not showing estrus previous to TAI.

2024-05-01·Gan to kagaku ryoho. Cancer & chemotherapy

[Recurrent Breast Cancer with Pulmonary Lymphangitis Carcinomatosis Case Responding to Trastuzumab Deruxtecan].

Article

作者: Sugimoto, Takashi ; Mizuta, Makoto ; Tsubono, Michihiko ; Fukui, Yukiko ; Tsubono, Masumi ; Endo, Shinichiro

Pulmonary lymphangitis carcinomatosis is generally characterized by resistance to chemotherapy and is associated with a poor prognosis. Herein, we present a case of pulmonary lymphangitic carcinomatosis from recurrent breast cancer that responded well to trastuzumab deruxtecan(T-DXd). The patient was a 40-year-old woman with hormone receptor-positive, HER2-positive breast cancer. At the age of 31, she had undergone a left mastectomy with axillary lymph node dissection. She received adjuvant chemotherapy(5-fluorouracil-epirubicin-cyclophosphamide, docetaxel, and trastuzumab)followed by endocrine therapy(tamoxifen and LH-RHa). Three years after the surgery, pulmonary and bone metastases were detected and she was treated with trastuzumab, pertuzumab, and capecitabine. Liver metastases were detected, and she was treated with trastuzumab emtansine. Nine years after surgery, the patient developed dyspnea and was diagnosed with lymphangitis carcinomatosis. After initiating T-DXd, dyspnea rapidly improved, and ground glass opacity on CT scan disappeared. She responded well to the treatment, with prolonged, stable disease for 1 year and 2 months. Thus, T-DXd may be effective against pulmonary lymphangitis carcinomatosis, which is generally characterized by resistance to chemotherapy.

2024-05-01·ChemPlusChem

A Novel Rhodamine‐Phenolphthalein Architecture for Selective Mercury Ion Detection in Aqueous Media

Article

作者: Kilic, Haydar ; Lafzi, Ferruh ; Bayindir, Sinan ; Hussein, Abdullah Saleh ; Toprak, Mahmut

Abstract:

In this study, the primary objective is to synthesize a novel fluorescent Rh‐PP‐Rh compound and explore its extensive range of photochemical behaviors. Initially, the synthesis of the novel Rh‐PP‐Rh was carried out for this purpose. Subsequently, UV‐Vis and fluorescence spectroscopy were employed to investigate the interactions between Rh‐PP‐Rh and a diverse array of ions in aqueous solvent systems. Through fluorescence and UV‐Vis studies, it was observed that Rh‐PP‐Rh demonstrated turn‐on sensor properties in the presence of Hg2+ ions. Furthermore, the limits of detection (LOD) and association constant (Ka) values for Rh‐PP‐Rh/Hg2+ were determined as 334 nM and 9.13×1011 M−2, respectively. Additionally, the reversible studies demonstrated a switchable on/off response upon alternate addition of HgCl2 and [Bu4N]F to Rh‐PP‐Rh. These findings suggest that the probe Rh‐PP‐Rh also possesses specific sensor properties for F− ions in the presence of mercury. In addition, the investigation encompassed an assessment of the visual analysis of the color alterations of Rh‐PP‐Rh both on filter paper and in an EtOH/H2O solution. The findings demonstrated that Rh‐PP‐Rh can be successfully utilized in solutions containing mercury, as it generates significant color transformations.

项与醋酸戈那瑞林相关的新闻（医药）

2024-04-07

·蒲公英Ouryao

羟苯磺酸钙口服制剂修订说明书

转自：国家药监局编辑：水晶4月7日，国家药监局发布了羟苯磺酸钙口服制剂（包括羟苯磺酸钙胶囊、羟苯磺酸钙片、羟苯磺酸钙分散片、羟苯磺酸钙颗粒）说明书内容进行统一修订。涉及药品：羟苯磺酸钙胶囊、羟苯磺酸钙片、羟苯磺酸钙分散片、羟苯磺酸钙颗粒。本次修订的是【不良反应】项和【注意事项】。备案截止日期：2024年6月30日前报国家药品监督管理局药品审评中心或省级药品监督管理部门备案。 2024年以来国家药监局已修订13个药品的说明书：羟苯磺酸钙口服制剂、西沙必利口服制剂、替硝唑注射剂、注射用戈那瑞林、复方妥英麻黄茶碱片、盐酸罂粟碱制剂、复方金银花颗粒、普乐安制剂、滑膜炎制剂、裸花紫珠制剂、祖卡木制剂、金刚藤制剂和斑秃丸。根据药品不良反应评估结果，为进一步保障公众用药安全，国家药监局决定对羟苯磺酸钙口服制剂（包括羟苯磺酸钙胶囊、羟苯磺酸钙片、羟苯磺酸钙分散片、羟苯磺酸钙颗粒）说明书内容进行统一修订。现将有关事项公告如下：一、上述药品的上市许可持有人均应当依据《药品注册管理办法》等有关规定，按照附件要求修订说明书，于2024年6月30日前报国家药品监督管理局药品审评中心或省级药品监督管理部门备案。修订内容涉及药品标签的，应当一并进行修订；说明书及标签其他内容应当与原批准内容一致。在备案之日起生产的药品，不得继续使用原药品说明书。药品上市许可持有人应当在备案后9个月内对已出厂的药品说明书及标签予以更换。二、药品上市许可持有人应当对新增不良反应发生机制开展深入研究，采取有效措施做好药品使用和安全性问题的宣传培训，指导医师、药师合理用药。三、临床医师、药师应当仔细阅读上述药品说明书的修订内容，在选择用药时，应当根据新修订说明书进行充分的获益/风险分析。四、患者用药前应当仔细阅读药品说明书，使用处方药的，应当严格遵医嘱用药。五、省级药品监督管理部门应当督促行政区域内上述药品的上市许可持有人按要求做好相应说明书修订和标签、说明书更换工作，对违法违规行为依法严厉查处。特此公告。附件：羟苯磺酸钙口服制剂说明书修订要求（包含羟苯磺酸钙胶囊OTC说明书）国家药监局 2024年4月1日附件羟苯磺酸钙口服制剂说明书修订要求（包含羟苯磺酸钙胶囊OTC说明书）一、【不良反应】项应包含但不限于：本品上市后监测到以下不良反应/事件：皮肤及皮下组织：瘙痒、潮红、皮疹（红斑、斑丘疹、水疱等）、荨麻疹；有中毒性表皮坏死松解症、大疱性表皮坏死松解型药疹、急性泛发型发疹性脓疱病、药物超敏反应综合征（DRESS综合征）等严重皮肤反应的个例报道。胃肠系统：腹部不适（如腹痛、腹泻、腹胀）、食欲减退、消化不良、胃肠道反应（如恶心、呕吐）。全身性疾病及给药部位各种反应：发热、畏寒、水肿、疲劳、乏力。血液和淋巴系统：粒细胞减少症、粒细胞缺乏症、白细胞减少症（白细胞计数降低）、中性粒细胞减少症。免疫系统：超敏反应、类过敏反应。肝胆系统：肝功能异常（如丙氨酸氨基转移酶升高）、肝细胞损伤。骨骼和结缔组织：关节痛、肌痛。神经系统：头晕、头痛。二、【注意事项】应包含但不限于： 1.非常罕见的情况下，羟苯磺酸钙可能导致粒细胞缺乏症。在这种情况下，可能出现包括高热、口腔感染（扁桃体炎）、咽喉痛、肛门与生殖器炎症及其他常见感染症状，一旦在治疗中出现这些症状，需立即停药，及时就医并评估血常规。 2.羟苯磺酸钙可能会诱发重度超敏反应（过敏反应或休克），如出现红斑、斑丘疹、水疱等皮肤反应，需立即停药，并及时就医。 3.严重肾功能不全需透析的病人应慎用。 4.服用羟苯磺酸钙会导致通过氧化酶法检测血肌酐的结果偏低。如果患者服用该药，应告知医生。

上市批准核酸药物

2024-01-25

·FierceBiotech

Silo Pharma’s ketamine-based drug for Alzheimer’s effective against dementia symptoms in mice

The new data shows that the drug reduces luteinizing hormone stress, which has been hypothesized to be a culprit in Alzheimer’s disease. Silo Pharma’s drug for Alzheimer’s dementia is effective at alleviating some of the condition’s psychological and behavioral symptoms in mice, according to the company. In a press release published Jan. 24, Silo said that its drug SPC-14—one formulation of which contains ketamine and another, undisclosed FDA-approved drug—reduced signs of anxiety, depression and repetitive behaviors in mice. SPC-14 was previously found to be effective at increasing memory function in mice as well. “We believe today’s announcement, along with our past studies of SPC-14 conducted in female rodents, lends credibility to our discovery of a therapeutic that could bring relief to patients and families suffering from Alzheimer’s disease,” Silo CEO and founder Eric Weisblum said in the release. He added that the company is looking forward to data “needed to advance SPC-14 to a clinical study.” SPC-14 targets N-methyl-D-aspartate receptors (NMDRS) and 5-HT4 receptors (5HT4RS), which are found on neurons in the brain. The new data shows that the drug reduces luteinizing hormone stress, which has been hypothesized to be a culprit in Alzheimer’s disease. Luteinizing hormone, or LH, controls sex hormone-related processes like the menstrual cycle and testosterone production. High circulating levels of LH in old age have been linked to cognitive decline in both mice and in humans. Other groups also are investigating how controlling luteinizing hormones can benefit Alzheimer’s patients. The Weill Cornell School of Medicine’s forthcoming LUCINDA clinical trial, which will include postmenopausal women with Alzheimer’s symptoms, pairs the injectable form of the prostate cancer medication leuprolide acetate, which suppresses luteinizing hormone release, with Eisai and Pfizer’s Aricept. Leuprolide acetate is commercialized by Tolmar as Eligard. Meanwhile, Silo is in the process of collecting preclinical data on the four other drugs in its pipeline. The company announced earlier this month that it had completed the first phase of a dose-ranging study for its SPC-15, an intranasal drug for PTSD prophylaxis. It received a regulatory greenlight in late December 2023 to begin development on a ketamine-loaded implant for fibromyalgia, SP-26, in partnership with Sever Pharma Solutions, and announced early positive data on its rheumatoid arthritis drug, SPU-21, in October 2023. Silo expects data on its peptide for multiple sclerosis, SPU-16, in mid-2024, according to the company’s website. Editor's Note: An earlier version of this article incorrectly called Silo Pharma by the incorrect name Silo Therapeutics. Also, in a follow-up message to FBR, Silo noted that it is also working on formulations of SPC-14 that do not contain ketamine. Both versions were tested in the study that resulted in the new preclinical data.

2022-07-29

·生物谷

走访健康守门人：迈入新时代，血小板减少症理念革新

CTIT的治疗指南推荐输注血小板和药物治疗，国内已经获批的CTIT治疗药物主要有白介素11（IL-11）和促血小板生成素（TPO）两种。 “走访健康守门人”专栏由《医师报》主办、三生制药公益支持，将从疫情防控、慢病管理等角度切入，生动展现各领域的医生帮助患者实现“健康触手可及”的历程，分享治疗理念，助力“健康中国2030”。马军教授：治疗理念革新，抗肿瘤治疗所致血小板减少症可防可治得了恶性肿瘤，规范、足量、不间断的治疗对于延长患者总生存期非常重要，但有一种抗肿瘤治疗引起的不良反应，严重到足以使抗肿瘤治疗减量甚至中断，这种不良反应非常常见，它就是抗肿瘤治疗所致血小板减少症（CTIT）。哈尔滨血液病肿瘤研究所所长马军教授表示，随着治疗理念的的革新和经验的丰富，CTIT正得到有效的防治。 CIT变CTIT，肿瘤治疗理念革新就在一字之差 “只有保证患者血小板水平，才能足时足量完成抗肿瘤治疗，患者的无进展生存期和总生存期不受影响。”马军教授介绍，“放化疗是肿瘤治疗基石，2000年以前，我们说的全都是肿瘤放化疗所致血小板减少症（CIT）。近年临床中逐渐认识到免疫治疗、细胞治疗、靶向治疗等新的治疗方式都可能引起血小板减少症，因此在最新的《肿瘤治疗所致血小板减少症诊疗指南（2022版）》正式将CIT概念拓展为CTIT。”CTIT概念的拓展也提示我们更加关注肿瘤全病程治疗中的出血风险。有效的药物+二级预防，CTIT发生率越来越低 “中国有两种CTIT治疗药物20年前已上市。”马军教授说，“一种是皮下注射白细胞介素11（IL-11），另一种是促血小板生成素（TPO）。两种药物都具有起效快、疗效可靠、不良反应小的特点，且对CTIT和CIT都有效。” 近几年，尽管已有多种新药获批用于CIT的治疗，但根据指南，CTIT治疗仍然以TPO和IL-11为主。马军教授也同时指出，虽然临床医生对于CIT治疗经验丰富，但针对CTIT，我们尚需积累更多的循证医学证据，包括防止过度治疗、应对不良反应（例如使用IL-11时，心脏方面不良反应和水钠潴留等）等，从而进一步完善指南。另外，随着CTIT和CIT的二级预防被写入指南，越来越多的临床医生会认识到“防治”的重要性，这类症状临床发生率会进一步降低。 “在‘以病人为中心’医疗改革的大背景下，肿瘤医生除了要重视抗肿瘤治疗，更应重视抗肿瘤治疗所致不良反应的防治，只有这样才能更好地实现2030年使恶性肿瘤患者5年无病生存率提高15%的远期目标。”马军教授强调。刘波教授：防患于未然，科学管理“血小板” 众所周知，血小板在血管损伤后的止血过程中起着重要作用。对于肿瘤患者，几乎所有的治疗方式均会导致血小板减少。一旦患者血小板减少，医生不得不通过降低药物剂量、延迟治疗时间、甚至通过终止治疗来应对，显然这是对治疗的一种妥协，会直接影响肿瘤的治疗效果；另外，随着血小板减少，患者出血的风险增加，严重者将危及生命。“血小板减少可引发一系列‘连锁反应’，导致治疗过程变得更复杂。” 山东省肿瘤医院刘波教授表示。纳入指南，疾病定义更清晰随着肿瘤治疗所致的血小板减少不再局限于化疗，靶向和免疫治疗等治疗方案均会导致血小板减少。所以在中国临床肿瘤学会（CSCO）的组织下，《2022版肿瘤治疗所致血小板减少症诊疗》指南中，将肿瘤化疗所致血小板减少症（CIT）正式拓展为肿瘤治疗所致血小板减少症（CTIT）。刘波教授指出，概念的革新不仅要与时俱进，同时在指南的规范化指导下，有利于医生综合的评估以及筛查，并及时给予CTIT患者更有利的全程管理治疗方案。分层评估、提前预防，科学管理促恢复由于CTIT在肿瘤治疗中发生率并不高，临床医生对它的重视和认知还存在不足。刘波教授指出，临床中首先要明确肿瘤患者发生CTIT的风险因素，并进行分层评估；对于已经发生CTIT的患者要及时进行病因评估，不同肿瘤治疗的手段导致CTIT的机制各不相同，要积极寻找病因，才能对症治疗；对于存在高风险的患者，应及时启动CTIT二级预防。新指南也特别强调“二级预防”的概念，即对于有出血风险高的患者，为预防下一个周期再发生严重的血小板减少，可预防性应用促血小板生长因子，以保证有关治疗的顺利进行。从新指南的治疗推荐级别来看，需要根据血小板的分层进行精准分组，并分层治疗。刘波教授认为，新指南中纳入的药物为国内获批的促血小板生成素(TPO)和白介素-11，这是一级推荐。尤其TPO能快速的提升血小板，缩短血小板减少持续的时间，安全性更好，临床证据也更加充分，是CTIT治疗首选的证据。总之，指南优先选择具有适应症的、起效快、安全的制剂，同时医生要密切观察用药后的不良反应，才能更快更有效地促进血小板的恢复。刘波教授强调，现代医学不仅要关注手术、放疗、化疗、靶向、免疫治疗的进展，也应该关注这些治疗所带来的不良反应，包括CTIT，还有肿瘤营养、癌痛、康复，以及身心问题，力争全方位、立体化、全流程的关注患者的症状管理，才能真正能够让患者活得久、活得好。让肿瘤患者真正能够体会到“生如夏花之绚烂，逝如秋叶之静美”的美好。徐小红主任：血小板减少症严重时可能威胁生命，治疗选择有讲究肿瘤治疗所致血小板减少症（CTIT）是肿瘤患者在治疗过程中最常见的不良反应之一。南通市肿瘤医院内科副主任兼血液内科主任徐小红介绍说，无论是放疗、化疗、靶向治疗，还是免疫治疗，这些常用的肿瘤治疗方法都会引起血小板减少。一旦发生CTIT，将影响化疗等肿瘤治疗手段的正常推进，患者严重时可能出现皮肤黏膜、消化系统、呼吸系统、泌尿生殖系统及颅内出血等，威胁生命安全。因此，治疗CTIT是每一位肿瘤科医生必须掌握的重要课题。多种药物选择，安全性为重目前，临床上能见到的CTIT治疗药物有三种，分别为重组人血小板生成素（rhTPO）、重组人白介素-11（rh IL-11）和促血小板生成素受体激动剂(TPO-RA)。具体而言，rhTPO是一种高特异性的血小板刺激因子，直接作用于骨髓造血干细胞，可调控血小板生成的各个阶段，特异性升高血小板，缩短血小板减少的持续时间，能够有效预防CTIT，安全性能良好，在临床中使用最广泛。rh IL-11是由造血微环境基质细胞和部分间叶细胞产生的多效性细胞因子，不良反应相对较大，具有一定的心脏的毒性，临床使用较为谨慎。TPO-RA是一大类小分子化合物，但因还未获批CTIT适应症，在临床上的应用相对较少。指南为纲，分级用药保护患者徐小红主任表示，在药物选择上，根据CSCO《2022版肿瘤治疗所致血小板减少症诊疗》指南，应首先考虑患者有无出血进行分组，如果患者出现出血，首选是输注血小板或联合rhTPO，II级推荐使用TPO-RA；若患者未发生出血，则根据血小板计数进行分层：如血小板计数在75 x 109/L-100 x 109/L之间，应密切观察血小板及出血情况，或直接输注血小板或联合rhTPO。如血小板计数在10 x 109/L-75 x 109/L之间，首选rhTPO，如果患者年纪相对较轻，或没有心脏基础疾患，可以适当选用rh IL-11。如果血小板计数更低，主要采用rhTPO，尽量不使用rh IL-11，因为使用rh IL-11一旦出现过敏或畏寒发热后，很可能引起出血等不良反应。 “医生、护士、患者三者要相互配合，才能把将血小板水平控制好。”徐小红主任强调，医护人员在面对CTIT时，要在依据指南用药的同时，密切观察患者用药后的不良反应，并和患者沟通好治疗中可能发生的情况，这样才能帮助患者按时完成后续的治疗，守护患者健康。宋盈主任：给肿瘤治疗引起血小板减少患者的“升板”用药小贴士 CTIT是肿瘤治疗常见的不良反应，当患者在使用导致CTIT的治疗药物，停药后血小板减少所致症状与体征减轻即可诊断CTIT。CTIT的治疗指南推荐输注血小板和药物治疗，国内已经获批的CTIT治疗药物主要有白介素11（IL-11）和促血小板生成素（TPO）两种。两种药物有何区别，该什么时候使用，《医师报》特邀湖北省十堰市人民医院宋盈主任介绍一下她的临床用药经验。分层用药兼顾效价造血干细胞“成长”为血小板，受到各种细胞因子调控。两种不同的药物IL-11和TPO，升血小板作用机理不同，作用于这一“成长通路”的位点也不同。宋盈主任介绍，IL-11是通过基因重组技术生产的促进血小板生长因子，可促进巨核细胞成熟，增加外周血小板数量，但它对血小板的功能无明显改善。TPO则全程调控巨核细胞和血小板生成过程，TPO的作用位点比IL-11早，所以TPO出现疗效时间比IL-11更早，而且持续时间更长。 “TPO 5~7天起效，10~14天达峰值，比IL-11快3天恢复目标血小板值，所以TPO对于中重度CTIT疗效优于IL-11。”宋盈教授说，如用到可能导致血小板降低药物，同时使用TPO还可预防血小板降低。对于轻度血小板降低患者，用IL-11更合适，因为价格比较便宜，患者易接受。根据身体状况择药居安思危 “我们科室承载很多75岁以上老年患者，他们代谢慢，药物清除慢，不良反应较大。此外，很多患者心脏情况不好，由于长期抗肿瘤治疗身体负担已经很重，所以在选择升血小板等辅助用药时，不良反应低成首要考虑标准。”宋盈主任说。 IL-11是生物制剂，所以一些患者用药后会出现发热，此外，其还有心脏毒性、发热、水肿、水钠潴留等问题。而TPO不良反应较小，一些基础研究还发现，它对心脏、神经系统有保护作用，所以适合对心脏影响较大的化疗药物使用患者、有基础心脏病患者，以及老年患者。宋盈主任提醒：由于很多晚期肿瘤患者是高凝状态，所以要用抗凝药物，如果升血小板药物使用TPO时，一般每周监测凝血功能和血常规，当凝血功能异常或血小板已正常时即可停药。

免疫疗法放射疗法CSCO会议细胞疗法抗体药物偶联物

100 项与醋酸戈那瑞林相关的药物交易

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外链

KEGG	Wiki	ATC	Drug Bank
D08027	-	H01CA01 V04CM01	DB00644

研发状态

10 条最早获批的记录,

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适应症	国家/地区	公司	日期
不孕	韩国	Handok, Inc.	1992-12-19
子宫内膜异位症	日本	Mitsubishi Tanabe Pharma Corp.	1989-01-17
性腺机能减退	日本	Nipro ES Pharma KK	1989-01-17
多囊卵巢综合征	日本	Mitsubishi Tanabe Pharma Corp.	1989-01-17
前列腺增生症	日本	Mitsubishi Tanabe Pharma Corp.	1989-01-17

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临床结果

适应症

分期

评价

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研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


ESPE2022	N/A	性早熟 kisspeptin-1 \| ghrelin \| estradiol ... 更多	-	Relefact LHRH®	鹽簾鑰襯蓋衊醖構夢衊(憲憲觸製廠壓淵構憲襯) = 鏇鏇衊鹹網選醖築鹽積廠淵範糧糧夢艱鬱蓋獵 (願簾築遞遞鹽鑰積膚積 )	-	2022-09-15
NCT01976728 (CTgov)	临床3期	继发性睾丸衰竭 \| 闭经	39	Gonadorelin acetate subcutaneous (SC) 10 μg/pulse as a fixed dose, administered via. OmniPod pump (LutrePulse 10 µg/Pulse)	襯構衊窪築襯淵餘憲願(壓糧構簾壓鏇顧製鬱鹽) = 淵糧顧淵鑰夢鏇遞壓壓壓壓構襯遞獵鑰糧餘選 (壓醖鹹鹽獵餘醖膚獵獵, 鏇遞遞選範積膚鬱製壓 ~ 蓋鹹窪願鏇範網壓艱獵) 更多	-	2021-03-03
				Gonadorelin acetate SC 15 μg/pulse as a fixed dose, administered via. OmniPod pump (LutrePulse 15 µg/Pulse)	襯構衊窪築襯淵餘憲願(壓糧構簾壓鏇顧製鬱鹽) = 蓋築鏇鏇構製構鹹鏇網壓壓構襯遞獵鑰糧餘選 (壓醖鹹鹽獵餘醖膚獵獵, 醖蓋蓋淵鹹餘憲鹹襯艱 ~ 觸鹹遞積壓衊淵網鏇窪) 更多
ASCO_GU2016	N/A	前列腺癌新辅助 \| 辅助	670	Buserelin	憲淵範衊蓋憲淵製繭構(憲鑰鬱鏇鹹廠糧選鹹廠) = 鏇餘鏇遞夢糧窪鹹製糧鏇廠醖顧淵艱衊顧蓋餘 (淵餘積獵顧膚壓壓鑰鹽 )	-	2016-01-10
				Goserelin	憲淵範衊蓋憲淵製繭構(憲鑰鬱鏇鹹廠糧選鹹廠) = 築選構顧艱網構襯膚選鏇廠醖顧淵艱衊顧蓋餘 (淵餘積獵顧膚壓壓鑰鹽 )
ASCO2015	N/A	早期乳腺癌	827	GnRHa	蓋築廠積築觸觸醖廠積(願蓋範願蓋繭膚顧廠簾): OR = 1.79 (95% CI, 0.97 ~ 3.31)	-	2015-05-20
				Placebo
NCT01457703 (CTgov)	N/A	肥胖	62	Recombinant LH+Cetrorelix+Letrozole+Gonadorelin-GnRH (BMI ≥30 kg/m2)	網積鬱顧繭齋選鑰構繭(窪獵襯窪鹽觸簾範選鏇) = 廠廠選築窪觸鏇壓襯膚壓簾餘膚壓範餘顧夢網 (願膚顧壓網積蓋蓋蓋鹹, 鑰範構夢築繭鏇醖網夢 ~ 獵蓋淵選蓋遞壓衊網觸) 更多	-	2015-03-25
				Recombinant LH+Cetrorelix+Letrozole+Gonadorelin-GnRH (BMI 18-25 kg/m2)	網積鬱顧繭齋選鑰構繭(窪獵襯窪鹽觸簾範選鏇) = 鹽餘積膚襯積簾獵選鏇壓簾餘膚壓範餘顧夢網 (願膚顧壓網積蓋蓋蓋鹹, 膚願觸網蓋鑰構顧範鑰 ~ 蓋憲憲壓淵簾鏇網憲鹹) 更多
Pubmed \| Fertil Steril	N/A	性早熟	-	GnRH agonist	製鹽獵顧壓淵選壓繭壓(築範齋觸遞齋齋壓獵艱) = 壓簾鹹齋顧鏇醖鏇憲膚壓製獵餘襯壓餘積構簾 (積鹹醖鬱夢醖鹽淵衊顧 )	-	2012-11-01
JMTO BC08-01 (ASCO2012)	临床2期	晚期乳腺癌	37	LH-RH analogue (GOS) + Aromatase inhibitor (ANA)	醖餘襯蓋範範鬱醖簾範(淵網淵鏇遞鑰獵憲廠範) = 築憲網夢積齋獵獵願糧獵淵製積選遞範蓋觸蓋 (廠蓋蓋餘衊觸遞鑰蓋餘, 8.0 ~ 35.2) 更多	-	2012-05-20