For heart transplant patients, there are a number of non-immunosuppressant medications that are routinely prescribed to mitigate the side-effects of immunosuppression, treat the related complications, and improve long...For heart transplant patients, there are a number of non-immunosuppressant medications that are routinely prescribed to mitigate the side-effects of immunosuppression, treat the related complications, and improve long-term survival. This review focuses on the medications used to prevent and manage cardiac allograft vasculopathy (CAV), hypertension, dyslipidemia and osteoporosis. The rationale and evidence supporting their use are summarized and the immunosuppressant drugs are only discussed briefly, as they relate to each of these medical issues. Pharmacy practitioners are likely to encounter patients post-cardiac transplant in a variety of clinical settings;therefore, a concise appreciation of the principles for the long-term medical management of these patients is important when providing collaborative care.展开更多
文摘目的:系统评价仙灵骨葆胶囊联合甲氨蝶呤治疗类风湿关节炎(rheumatoid arthritis,RA)继发骨质疏松症(osteoporosis,OP)的有效性,为中药治疗该病提供参考依据。方法:检索the Cochrane Library、PubMed、EMBase、中国知网、万方数据库、中国生物医学文献数据库和维普数据库,纳入比较仙灵骨葆胶囊联合甲氨蝶呤(研究组)与单独使用甲氨蝶呤(对照组)治疗RA继发OP的随机对照试验(randomized controlled trial,RCT),检索时限从建库起至2020年10月。按纳入与排除标准筛选文献、提取资料并评价纳入研究的方法学质量后,采用Rev Man 5.4软件进行荟萃分析(Meta分析)。结果:共4篇RCT文献纳入分析,包括270例患者,其中研究组患者135例,对照组患者135例。分别对显效率、总有效率、骨密度(bone mineral density,BMD)、晨僵时间和关节功能指数进行有效性评价。Meta分析结果显示,两组患者在显效率(RR=1.59,95%CI=1.16~2.20,P=0.005)、总有效率(RR=1.29,95%CI=1.13~1.48,P=0.0003)、股骨颈BMD(MD=0.03,95%CI=0.02~0.04,P<0.00001)、晨僵时间(MD=-6.17,95%CI=-7.72~-4.63,P<0.00001)和关节功能指数(MD=-0.33,95%CI=-0.39~-0.27,P<0.00001)等方面的差异均有统计学意义,研究组患者上述指标明显优于对照组;两组患者腰椎BMD比较,差异无统计学意义(MD=0.05,95%CI=-0.00~0.10,P=0.06>0.05)。结论:仙灵骨葆胶囊可有效提高甲氨蝶呤治疗RA继发OP的显效率、总有效率,改善股骨颈BMD、晨僵时间和关节功能指数。
文摘For heart transplant patients, there are a number of non-immunosuppressant medications that are routinely prescribed to mitigate the side-effects of immunosuppression, treat the related complications, and improve long-term survival. This review focuses on the medications used to prevent and manage cardiac allograft vasculopathy (CAV), hypertension, dyslipidemia and osteoporosis. The rationale and evidence supporting their use are summarized and the immunosuppressant drugs are only discussed briefly, as they relate to each of these medical issues. Pharmacy practitioners are likely to encounter patients post-cardiac transplant in a variety of clinical settings;therefore, a concise appreciation of the principles for the long-term medical management of these patients is important when providing collaborative care.
