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Relationship between response to lusutrombopag and splenic volume

World Journal of Gastroenterology 2018年第46期24卷 5271-5279页

作者： Haruki Uojima Yoshitaka Arase norio itokawa Masanori Atsukawa Takashi Satoh Koji Miyazaki Hisashi Hidaka Ji Hyun Sung Makoto Kako Kota Tsuruya Tatehiro Kagawa Katsuhiko Iwakiri Ryouichi Horie Wasaburo Koizumi Department of Gastroenterology Shonan Kamakura General Hospital Department of Gastroenterology Internal MedicineKitasato University School of Medicine Division of Gastroenterology and Hepatology Department of Internal MedicineTokai University School of Medicine Department of Internal Medicine Division of GastroenterologyNippon Medical School Chiba Hokusoh Hospital Department of Internal Medicine Division of Gastroenterology and HepatologyNippon Medical School Division of Hematology Department of Medical Laboratory SciencesKitasato University School of Allied Health Sciences Division of Molecular Hematology Kitasato University Graduate School of Medical Sciences Department of Transfusion and Cell Transplantation Kitasato University School of Medicine

AIM To assess the correlation between the efficacy of lusutrom-bopag and clinical characteristics in patients with chronic liver *** In this retrospective, multicenter study, which conducted at four locations in Japan, 50 thrombocytopenic patients with chronic liver disease were enrolled. All patients received oral lusutrombopag(3.0 mg/d for 7 d) for chronic liver disease. We assessed the increase in platelet count after the trial drug administration. A treatment response was defined as a platelet count ≥ 5 × 104/μL and an increased platelet count ≥ 2 × 104/μL from baseline after drug administration. We evaluated the response to lusutrombopag compared to baseline clinical characteristics in patients with chronic liver *** The numbers of responders and non-responders were 40(80.0%) and 10(20.0%), respectively. The patients were divided into a responder and non-responder group, and we added factors that may correspond to successful treatment with lusutrombopag. Splenic volume and body weight were lower in the responder group than in the nonresponder group. White blood cell count and hemoglobin level were higher in responders compared with nonresponders. Using a logistic regression model to assess the relationship between response to lusutrombopag and clinical characteristics, multivariate analysis confirmed that splenic volume was an independent factor that predicted the response of platelet counts(P = 0.025; odds ratio = 11.2; 95% confidence interval: 1.354-103.0). Splenic volume negatively correlated to changes in platelet count(r =-0.524, P = 0.001).CONCLUSION Splenic volume influences the change in platelet counts after administration of lusutrombopag in patients with chronic liver disease.

关键词： Lusutrombopag Portal hypertension Splenic volume Thrombocytopenia Thrombopoietin receptor agonist

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Usefulness of portal vein pressure for predicting the effects of tolvaptan in cirrhotic patients

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World Journal of Gastroenterology 2016年第21期22卷 5104-5113页

作者： Ai Nakagawa Masanori Atsukawa Akihito Tsubota Chisa Kondo Tomomi Okubo Taeang Arai norio itokawa Yoshiyuki Narahara Katsuhiko Iwakiri Division of Gastroenterology Department of Internal Medicine Nippon Medical School Chiba Hokusoh Hospital Core Research Facilities for Basic Science Research Center for Medical Sciences Jikei University School of Medicine Division of Gastroenterology Department of Internal Medicine Nippon Medical School

AIM: To elucidate influencing factors of treatment response, then tolvaptan has been approved in Japan for liquid ***: We herein conducted this study to clarify the influencing factors in 40 patients with decompensated liver cirrhosis complicated by liquid retention. Tolvaptan was administered at a dosage of 7.5 mg once a day for patients with conventional diuretic-resistant hepatic edema for 7 d. At the initiation of tolvaptan, the estimated hepatic venous pressure gradient(HVPG) value which was estimated portal vein pressure was measured using hepatic venous catheterization. We analyzed the effects of tolvaptan and influencing factors associated with treatment ***: Subjects comprised patients with a median age of 65(range, 40-82) years. According to the ChildPugh classification, class A was 3 patients, class B was 19, and class C was 18. Changes from the baseline in body weight were-1.0 kg(P = 2.04 × 10^(-6)) and-1.3 kg(P = 1.83 × 10^(-5)), respectively. The median HVPG value was 240(range, 105-580) mm H2 O. HVPG was only significant influencing factor of the weight loss effect. When patients with body weight loss of 2 kg or greater from the baseline was defined as responders, receiver operating characteristic curve analysis showed that the optimal HVPG cutoff value was 190 mm H_2 O in predicting treatment response. The response rate was 87.5%(7/8) in patients with HVPG of 190 mm H2 O or less, whereas it was only 12.5%(2/16) in those with HVPG of greater than 190 mm H2O(P = 7.46 × 10^(-4)). We compared each characteristics factors between responders and non-responders. As a result, HVPG(P = 0.045) and serum hyaluronic acid(P = 0.017) were detected as useful ***: The present study suggests that tolvaptan in the treatment of liquid retention could be more effective for patients with lower portal vein pressure.

关键词： Tolvaptan V2 receptor antagonist Portal vein pressure Hepatic venous pressure gradient Decompensated

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雷莫芦单抗用于经乐伐替尼治疗后进展的不可切除肝细胞癌的治疗效果

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Gastroenterology Report 2021年第2期9卷 133-138,I0002页

作者： Atsushi Hiraoka Takashi Kumada Toshifumi Tada Chikara Ogawa Joji Tani Shinya Fukunishi Masanori Atsukawa Masashi Hirooka Kunihiko Tsuji Toru Ishikawa Koichi Takaguchi Kazuya Kariyama Ei Itobayashi Kazuto Tajiri Noritomo Shimada Hiroshi Shibata Hironori Ochi Kazuhito Kawata Hidenori Toyoda Hideko Ohama Kazuhiro Nouso Akemi Tsutsui Takuya Nagano norio itokawa Korenobu Hayama Taeang Arai Michitaka Imai Yohei Koizumi Shinichiro Nakamura Kojiro Michitaka Yoichi Hiasa Masatoshi Kudo Gastroenterology Center Ehime Prefectural Central HospitalEhimeJapan Department of Gastroenterology and Hepatology Ogaki Municipal HospitalGifuJapan Department of Internal Medicine Himeji Red Cross HospitalHyogoJapan Department of Gastroenterology and Hepatology Takamatsu Red Cross HospitalTakamatsuJapan Department of Gastroenterology and Hepatology Kagawa universityKagawaJapan Department of Gastroenterology Osaka Medical CollegeOsakaJapan Division of Gastroenterology and Hepatology Department of Internal MedicineNippon Medical SchoolTokyoJapan Department of Gastroenterology and Metabology Ehime University Graduate School of MedicineEhimeJapan Center of Gastroenterology Teine Keijinkai HospitalSapporoJapan Department of Gastroenterology Saiseikai Niigata HospitalNiigataJapan Department of Hepatology Kagawa Prefectural Central HospitalTakamatsuJapan Department of Gastroenterology Okayama City HospitalOkayamaJapan Department of Gastroenterology Asahi General HospitalAsahiJapan Department of Gastroenterology Toyama University HospitalToyamaJapan Division of Gastroenterology and Hepatology Otakanomori HospitalKashiwaJapan Department of Gastroenterology Tokushima Prefectural Central HospitalTokushimaJapan Hepato-biliary Center Matsuyama Red Cross HospitalMatsuyamaJapan Department of Hepatology Hamamatsu University School of MedicineHamamatsuJapan Department of Gastroenterology Kindai UniversityOsakaJapan

背景:在日本,乐伐替尼可用于不可切除原发性肝癌的一线、二线或三线治疗。本研究评估新近研发的雷莫芦单抗用于经乐伐替尼治疗后进展的不可切除的原发性肝癌的疗效。方法:2018年5月至2020年1月间在日本16家中心接受乐伐替尼治疗的385例... 详细信息

背景:在日本,乐伐替尼可用于不可切除原发性肝癌的一线、二线或三线治疗。本研究评估新近研发的雷莫芦单抗用于经乐伐替尼治疗后进展的不可切除的原发性肝癌的疗效。方法:2018年5月至2020年1月间在日本16家中心接受乐伐替尼治疗的385例不可切除原发性肝癌患者中,我们将其中接受雷莫芦单抗作为下一线治疗的28例患者纳入研究,对其治疗效果进行回顾性分析。结果:28例患者中位年龄70岁,中位白蛋白-胆红素(ALBI)评分为2.19。28例患者中,23例为男性;21例为Child-Pugh A级,7例为Child-Pugh B级;3例为BCLC B期,25例为BCLC C期。雷莫芦单抗用于二线、三线和四线治疗的病例分别为14例、9例和5例患者。26例患者获得疗效评估,客观缓解率为3.8%(1/26),疾病控制率为42.3%(11/26);中位疾病进展时间为2个月。未继续接受雷莫芦单抗治疗的原因包括16例出现疾病进展和2例出现3级不良反应(消化道出血和腹水)。结论:我们的初步研究显示,对于乐伐替尼治疗进展的不可切除原发性肝癌,雷莫芦单抗并没有获得预期的治疗效果。

关键词： hepatocellular carcinoma ramucirumab lenvatinib sorafenib

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