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Current status of novel biologics and small molecule drugs in the individualized treatment of inflammatory bowel disease 被引量:1
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作者 Yi-Han Xu Wei-Ming Zhu Zhen Guo 《World Journal of Gastroenterology》 SCIE CAS 2022年第48期6888-6899,共12页
Treatment strategies for inflammatory bowel disease(IBD)are rapidly evolving with the development of biologics and small molecule drugs(SMDs).However,these drugs are not guaranteed to be effective in all patients,and ... Treatment strategies for inflammatory bowel disease(IBD)are rapidly evolving with the development of biologics and small molecule drugs(SMDs).However,these drugs are not guaranteed to be effective in all patients,and a“ceiling effect”of biologic monotherapy may occur.This issue highlights an unmet need for optimizing the use of biologics and predicting therapeutic responses.Thus,the development of new drugs with novel mechanisms of action is urgently needed for patients with primary nonresponse and secondary loss of response to conventional biologics and SMDs.In addition,combining different biologics or SMDs has been proposed as a novel strategy to enhance treatment efficacy in IBD,which theoretically has multidimensional anti-inflammatory potential.Based on the current evidence available for IBD,dual targeted therapy may be a promising strategy for refractory IBD patients who have failed in multiple biologic treatments or who have extraintestinal manifestation.Additionally,identifying the subgroup of IBD patients who are responding to biological combination therapies is also equally important in stable disease remission.In this review,we summarize the newly developed biologics and SMDs and the current status of biologics/SMDs to highlight the development of individualized treatment in IBD. 展开更多
关键词 Inflammatory bowel diseases BIOLOGIC dual targeted therapy Therapeutic drug monitoring Bispecific antibodies
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Enhanced Precision Therapy of Multiple Myeloma Through Engineered Biomimetic Nanoparticles with Dual Targeting
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作者 Ruogu Qi Shanshan Wang +8 位作者 Jiayi Yu Tianming Lu Zhiqiang Bi Weibo Liu Yuanyuan Guo Yong Bian Jianliang Shen Xuesong Zhang Wenhao Hu 《Engineering》 SCIE EI CAS CSCD 2024年第5期178-192,共15页
Multiple myeloma(MM)is the second most prevalent hematological malignancy.Current MM treatment strategies are hampered by systemic toxicity and suboptimal therapeutic efficacy.This study addressed these limitations th... Multiple myeloma(MM)is the second most prevalent hematological malignancy.Current MM treatment strategies are hampered by systemic toxicity and suboptimal therapeutic efficacy.This study addressed these limitations through the development of a potent MM-targeting chemotherapy strategy,which capitalized on the high binding affinity of alendronate for hydroxyapatite in the bone matrix and the homologous targeting of myeloma cell membranes,termed T-PB@M.The results from our investigations highlight the considerable bone affinity of T-PB@M,both in vitro and in vivo.Additionally,this material demonstrated a capability for drug release triggered by low pH conditions.Moreover,T-PB@M induced the generation of reactive oxygen species and triggered cell apoptosis through the poly(ADP-ribose)polymerase 1(PARP1)-Caspase-3-B-cell lymphoma-2(Bcl-2)pathway in MM cells.Notably,T-PB@M preferentially targeted bone-involved sites,thereby circumventing systemic toxic side effects and leading to prolonged survival of MM orthotopic mice.Therefore,this designed target-MM nanocarrier presents a promising and potentially effective platform for the precise treatment of MM. 展开更多
关键词 Multiple myeloma BORTEZOMIB drug delivery dual targeting Controlled release
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Liposomal dual delivery systems in visceral leishmaniasis enhance the synergistic effects of combination therapy:A promise for the future
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作者 Raghunath Hazra Amrita Kar Santanu Kar Mahapatra 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2024年第2期47-60,共14页
Visceral leishmaniasis(VL)is a neglected tropical disease,and this review has summarized the current treatment scenario and its prospects.It also highlights alternative approaches used by research groups in India and ... Visceral leishmaniasis(VL)is a neglected tropical disease,and this review has summarized the current treatment scenario and its prospects.It also highlights alternative approaches used by research groups in India and around the world to develop cutting-edge and potent anti-leishmanial treatments.Even though numerous medications could be utilized to treat VL,the limitations of current treatments including their toxicity,cost,route of administration,and duration of doses,have contributed to the emergence of resistance.Combination therapy might be a better option due to its shorter duration,easier route of administration,and ability to extend the lifespan of individual drugs.However,there is a risk of not delivering both the drugs to the target site together,which can be overcome by the liposomal entrapment of those drugs and at a time knock an opportunity to reduce the dosage of amphotericin B if the combination drug provides a synergistic effect with it.Therefore,this review presents a novel strategy to fight against VL by introducing dual drug-loaded liposomes. 展开更多
关键词 Visceral leishmaniasis Liposomal anti-leishmanial drug dual drug liposome
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High-throughput computational screening and in vitro evaluation identifies 5-(4-oxo-4H-3,1-benzoxazin-2-yl)-2-[3-(4-oxo-4H-3,1-benzoxazin-2-yl)phenyl]-1H-isoindole-1,3(2H)-dione(C3),as a novel EGFR—HER2 dual inhibitor in gastric tumors
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作者 MESFER AL SHAHRANI REEM GAHTANI +5 位作者 MOHAMMAD ABOHASSAN MOHAMMAD ALSHAHRANI YASSER ALRAEY AYED DERA MOHAMMAD RAJEH ASIRI PRASANNA RAJAGOPALAN 《Oncology Research》 SCIE 2024年第2期251-259,共9页
Gastric cancers are caused primarily due to the activation and amplification of the EGFR or HER2 kinases resulting in cell proliferation,adhesion,angiogenesis,and metastasis.Conventional therapies are ineffective due ... Gastric cancers are caused primarily due to the activation and amplification of the EGFR or HER2 kinases resulting in cell proliferation,adhesion,angiogenesis,and metastasis.Conventional therapies are ineffective due to the intra-tumoral heterogeneity and concomitant genetic mutations.Hence,dual inhibition strategies are recommended to increase potency and reduce cytotoxicity.In this study,we have conducted computational high-throughput screening of the ChemBridge library followed by in vitro assays and identified novel selective inhibitors that have a dual impediment of EGFR/HER2 kinase activities.Diversity-based High-throughput Virtual Screening(D-HTVS)was used to screen the whole ChemBridge small molecular library against EGFR and HER2.The atomistic molecular dynamic simulation was conducted to understand the dynamics and stability of the protein-ligand complexes.EGFR/HER2 kinase enzymes,KATOIII,and Snu-5 cells were used for in vitro validations.The atomistic Molecular Dynamics simulations followed by solvent-based Gibbs binding free energy calculation of top molecules,identified compound C3(5-(4-oxo-4H-3,1-benzoxazin-2-yl)-2-[3-(4-oxo-4H-3,1-benzoxazin-2-yl)phenyl]-1H-isoindole-1,3(2H)-dione)to have a good affinity for both EGFR and HER2.The predicted compound,C3,was promising with better binding energy,good binding pose,and optimum interactions with the EGFR and HER2 residues.C3 inhibited EGFR and HER2 kinases with IC50 values of 37.24 and 45.83 nM,respectively.The GI50 values of C3 to inhibit KATOIII and Snu-5 cells were 84.76 and 48.26 nM,respectively.Based on these findings,we conclude that the identified compound C3 showed a conceivable dual inhibitory activity on EGFR/HER2 kinase,and therefore can be considered as a plausible lead-like molecule for treating gastric cancers with minimal side effects,though testing in higher models with pharmacokinetic approach is required. 展开更多
关键词 dual inhibitor drug discovery EGFR/HER2 kinase Gastric cancer High-throughput screening
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Surface-engineered liposomes for dual-drug delivery targeting strategy against methicillin-resistant Staphylococcus aureus(MRSA) 被引量:1
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作者 Nur Najihah Izzati Mat Rani Xiang Yi Chen +10 位作者 Zahraa M.Al-Zubaidi Hanisah Azhari Tzar Mohd Nizam Khaitir Pei Yuen Ng Fhataheya Buang Geok Chin Tan Yin Ping Wong Mazlina Mohd Said Adeel Masood Butt Azmy A.Hamid Mohd Cairul Iqbal Mohd Amin 《Asian Journal of Pharmaceutical Sciences》 SCIE CAS 2022年第1期102-119,共18页
This study focused on the encapsulation of vancomycin(VAN) into liposomes coated with a red blood cell membrane with a targeting ligand, daptomycin–polyethylene glycol–1,2-distearoyl-sn-glycero-3-phosphoethanolamine... This study focused on the encapsulation of vancomycin(VAN) into liposomes coated with a red blood cell membrane with a targeting ligand, daptomycin–polyethylene glycol–1,2-distearoyl-sn-glycero-3-phosphoethanolamine, formed by conjugation of DAPT and Nhydroxysuccinimidyl-polyethylene glycol-1,2-distearoyl-sn-glycero-3-phosphoethanolamine.This formulation is capable of providing controlled and targeted drug delivery to the bacterial cytoplasm. We performed MALDI-TOF, NMR and FTIR analyses to confirm the conjugation of the targeting ligand via the formation of amide bonds. Approximately 45% of VAN could be loaded into the aqueous cores, whereas 90% DAPT was detected using UV–vis spectrophotometry. In comparison to free drugs, the formulations controlled the release of drugs for > 72 h. Additionally, as demonstrated using CLSM and flow cytometry, the resulting formulation was capable of evading detection by macrophage cells. In comparison to free drugs, red blood cell membrane–DAPT–VAN liposomes, DAPT liposomes, and VAN liposomes reduced the MIC and significantly increased bacterial permeability, resulting in > 80% bacterial death within 4 h. Cytotoxicity tests were performed in vitro and in vivo on mammalian cells,in addition to hemolytic activity tests in human erythrocytes, wherein drugs loaded into the liposomes and RBCDVL exhibited low toxicity. Thus, the findings of this study provide insight about a dual antibiotic targeting strategy that utilizes liposomes and red blood cell membranes to deliver targeted drugs against MRSA. 展开更多
关键词 ERYTHROCYTE dual drug delivery Liposome Methicillin-resistant staphylococcus aureus VANCOMYCIN DAPTOMYCIN
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Preparation and Characterization of Superparamagnetic Fe_3O_4/CNTs Nanocomposites Dual-drug Carrier 被引量:2
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作者 张小娟 郝凌云 +4 位作者 WANG Hehe ZHU Xingqun ZHANG Zhiying HU Xiaohong JIANG Wei 《Journal of Wuhan University of Technology(Materials Science)》 SCIE EI CAS 2017年第1期42-46,共5页
Fe3O4/carbon nanotubes(Fe3O4/CNTs) nanocomposites were prepared by polylol hightemperature decomposition of the precursor ferric chloride and CNTs in liquid triethylene glycol.After surface modification with hexaned... Fe3O4/carbon nanotubes(Fe3O4/CNTs) nanocomposites were prepared by polylol hightemperature decomposition of the precursor ferric chloride and CNTs in liquid triethylene glycol.After surface modification with hexanediamine,folate was covalently linked to the amine group of magnetic Fe3O4/CNTs nanocomposites.The products were characterized by Fourier-transform infrared spectroscopy,transmission electron microscopy,and vibrating sample magnetometry.Then Fe3O4/CNTs were used as a dual-drug carrier to co-delivery of the hydrophilic drug epirubicin hydrochloride and hydrophobic drug paclitaxel.The results indicated that the Fe3O4/CNTs had a favorable release property for epirubicin and paclitaxel,and thus had potential application in tumor-targeted combination chemotherapy. 展开更多
关键词 Fe3O4/CNTs NANOCOMPOSITES dual-drug carrier EPIRUBICIN PACLITAXEL
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Facile Approach to Synthesize Gold Nanorod@Polyacrylic Acid/Calcium Phosphate Yolk–Shell Nanoparticles for Dual-Mode Imaging and pH/NIR-Responsive Drug Delivery 被引量:4
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作者 Guilan Li Yidan Chen +5 位作者 Lingyu Zhang Manjie Zhang Shengnan Li Lu Li Tingting Wang Chungang Wang 《Nano-Micro Letters》 SCIE EI CAS 2018年第1期63-73,共11页
A facile strategy to fabricate gold nanorod@polyacrylic acid/calcium phosphate(Au NR@-PAA/Ca P) yolk–shell nanoparticles(NPs) composed with a PAA/Ca P shell and an Au NR yolk is reported. The asobtained Au NR@PAA/Ca ... A facile strategy to fabricate gold nanorod@polyacrylic acid/calcium phosphate(Au NR@-PAA/Ca P) yolk–shell nanoparticles(NPs) composed with a PAA/Ca P shell and an Au NR yolk is reported. The asobtained Au NR@PAA/Ca P yolk–shell NPs possess ultrahigh doxorubicin(DOX) loading capability(1 mg DOX/mg NPs), superior photothermal conversion property(26%)and p H/near-infrared(NIR) dual-responsive drug delivery performance. The released DOX continuously increased due to the damage of the Ca P shell at low p H values. When the DOX-loaded Au NR@PAA/Ca P yolk–shell NPs wereexposed to NIR irradiation, a burst-like drug release occurs owing to the heat produced by the Au NRs. Furthermore,Au NR@PAA/Ca P yolk–shell NPs are successfully employed for synergic dual-mode X-ray computed tomography/photoacoustic imaging and chemo-photothermal cancer therapy. Therefore, this work brings new insights for the synthesis of multifunctional nanomaterials and extends theranostic applications. 展开更多
关键词 Yolk–shell structure Calcium phosphate dual-mode imaging Photothermal therapy drug delivery
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Duration of dual antiplatelet treatment in the era of next generation drug-eluting stents 被引量:1
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作者 Seung-Woon Rha 《World Journal of Cardiology》 CAS 2014年第4期148-153,共6页
Current percutaneous coronary intervention guidelines recommend dual antiplatelets(aspirin 100 mg + clopidogrel 75 mg daily) for at least 12 mo following drugeluting stent(DES) implantation if patients are not at high... Current percutaneous coronary intervention guidelines recommend dual antiplatelets(aspirin 100 mg + clopidogrel 75 mg daily) for at least 12 mo following drugeluting stent(DES) implantation if patients are not at high risk of bleeding.Several reports have tried to shorten the dual antiplatelet therapy to 3-6 mo,especially following next-generation DES implantation,for cost-effectiveness.However,the clinical results are inconsistent and the data regarding next-generation DESs limited.In this report,recently published important pivotal reports regarding the optimal duration of dual antiplatelets following DES implantation are summarized. 展开更多
关键词 drug-ELUTING STENT dual ANTIPLATELET treatment PERCUTANEOUS CORONARY intervention
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Polymeric Hydrogel Nanocapsules: A Thermo and pH Dual-responsive Carrier for Sustained Drug Release
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作者 Jingya Nan Ying Chen +4 位作者 Rutian Li Jifu Wang Meihong Liu Chunpeng Wang Fuxiang Chu 《Nano-Micro Letters》 SCIE EI CAS 2014年第3期200-208,共9页
Hydrogel capsules show attractive prospects in drug delivery recently because of high drug loading and sustained release behavior. In this study we reported a simple and convenient route to fabricate poly(acrylic acid... Hydrogel capsules show attractive prospects in drug delivery recently because of high drug loading and sustained release behavior. In this study we reported a simple and convenient route to fabricate poly(acrylic acid)-poly(N-isopropylacrylamide)(PAA-PNIPAm) hydrogel capsules by using hydroxypropylcellulose-poly(acrylic acid)(HPC-PAA) complexes as the templates. The capsules showed a high drug loading(~280% to the weight of capsules) for Doxorubicin hydrochloride. The release of drug from the capsules was responsive to the temperature and p H of the surroundings, showing a low-rate but sustained release behavior favorable for low-toxic and long-term therapy. Together with the convenient preparation, high drug loading, dual responsivity as well as the sustained release feature, it is implied that this polymeric hydrogel capsule might be a promising candidate for new drug carriers. 展开更多
关键词 Hydrogel capsules Sustained release High drug loading dual responsivity
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Efficacy of Short-term Dual Antiplatelet Therapy after Implantation of Second-generation Drug-eluting Stents:A Meta-analysis and Systematic Review
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作者 Peisen Huang Yuan Yu +1 位作者 Xikun Han Yuejin Yang 《Chinese Medical Sciences Journal》 CAS CSCD 2017年第1期1-12,共12页
Objective The benefit of short-term dual antiplatelet therapy(DAPT) following second-generation drug-eluting stents implantation has not been systematically evaluated. To bridge the knowledge gap,we did a meta-analysi... Objective The benefit of short-term dual antiplatelet therapy(DAPT) following second-generation drug-eluting stents implantation has not been systematically evaluated. To bridge the knowledge gap,we did a meta-analysis to assess the efficacy of ≤6 months versus ≥12 months DAPT among patients with second-generation drug-eluting stents. Methods We searched online databases and identified randomized controlled trials that assess the clinical impact of short-term DAPT(≤6 months) published before March 3,2016. The efficacy endpoints included the incidence of all-cause death,myocardial infarction,cerebrovascular accidents,and definite or probable stent thrombosis. Safety endpoint defined as major bleeding was also evaluated and discussed. Results We included 5 trials that randomized 9473 participants(49.8%,short-term DAPT duration vs. 50.2%,standard duration). A total of 9445(99.7%) patients reported the efficacy endpoints,and the safety endpoint was available from 4 studies(n=8457). There was no significant difference in efficacy endpoints between short-term and standard DAPT duration(≥12 months) [risk ratio(RR) 0.96; 95% confidence intervals(CI),0.80-1.15]. Short-term DAPT duration did not significantly increase the individual risk of all-cause death,myocardial infarction,cerebrovascular accidents,or definite or probable stent thrombosis. Although short-term DAPT obviously reduced risk of major bleeding compared with standard DAPT(RR 0.53; 95% CI,0.29-0.96),significant publication bias was found when accessing the safety endpoint of the 4 studies(Egger's test,P=0.009). Conclusions The efficacy of short-term DAPT was comparable with that of standard duration DAPT.DAPT less than 6 months may be appropriate for patients receiving second-generation drug-eluting stents implantation. 展开更多
关键词 META-ANALYSIS drug-ELUTING STENTS dual ANTIPLATELET therapy PERCUTANEOUS coronary intervention EFFICACY
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Preparation of Magnetic Fluorescent Dual-drug Nanocomposites for Codelivery of Kaempferol and Paclitaxel
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作者 张小娟 PAN Qingqing +5 位作者 郝凌云 LIN Qing TIAN Xiangping ZHANG Zhiying WANG Shanshan WANG Hehe 《Journal of Wuhan University of Technology(Materials Science)》 SCIE EI CAS 2018年第1期256-262,共7页
Magnetic fluorescent dual-drug nanocomposites(MFDDs) were developed with the aim of simultaneouly delivering two different anticancer drugs, kaempferol(KAE) and paclitaxel(PTX). Firstly, Fe3O4/bovine serum albu... Magnetic fluorescent dual-drug nanocomposites(MFDDs) were developed with the aim of simultaneouly delivering two different anticancer drugs, kaempferol(KAE) and paclitaxel(PTX). Firstly, Fe3O4/bovine serum albumin(Fe3O4/BSA) composite microspheres with physically entrapped KAE were prepared, then microspheres were modified with PTX/graphene quantum dots(PTX/GQDs) through chemically bonding, and the MFDDs were obtained. The properties of nancomposites were characterized by X-ray diffractometry, Fourier-transform infrared spectroscopy, transmission electron microscopy, vibrating sample magnetometry and X-ray fluorescence spectrometry. It was found that the superparamagnetic nanocomposites had ultrafine size(below 110 nm), high saturation magnetization of 24.36 emu/g, and significant fluorescence. Furthermore, the cumulative in vitro release of the MFDDs exhibited controlled drug release. Cell viability experiments confirmed that the co-administration of KAE with PTX had a superior cytotoxicity to the Hela cells compared with single drug-loaded forms. Therefore, dual anticancer drug-loaded MFDDs have the potential to be used for cancer combined chemotherapy. 展开更多
关键词 dual-drug delivery NANOCOMPOSITES graphene quantum dots KAEMPFEROL PACLITAXEL Hela cells
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双靶向新辅助药物联合不同化疗治疗HER-2阳性乳腺癌临床疗效比较
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作者 陈方红 高东 +2 位作者 张平宇 周杰 黄亮 《中国药业》 CAS 2024年第8期95-99,共5页
目的探讨双靶向新辅助药物联合不同化学药物治疗(简称化疗)的方案治疗人类表皮生长因子受体-2(HER-2)阳性乳腺癌的临床疗效。方法选取凉山彝族自治州第一人民医院2019年1月至2022年12月收治的HER-2阳性乳腺癌患者110例,按治疗方案的不... 目的探讨双靶向新辅助药物联合不同化学药物治疗(简称化疗)的方案治疗人类表皮生长因子受体-2(HER-2)阳性乳腺癌的临床疗效。方法选取凉山彝族自治州第一人民医院2019年1月至2022年12月收治的HER-2阳性乳腺癌患者110例,按治疗方案的不同分为TcbHP组和AC-THP组,各55例。TcbHP组患者予曲妥珠单抗和帕妥珠单抗联合紫杉类(多西他赛或紫杉醇)和卡铂治疗,以21 d为1个周期,共治疗6个周期;AC-THP组患者予曲妥珠单抗和帕妥珠单抗联合蒽环类药物(吡柔比星或表柔比星)和环磷酰胺治疗,以21 d为1个周期,曲妥珠单抗和帕妥珠单抗及其他药物分别治疗4个周期,共8个周期。结果TcbHP组患者病理完全缓解率为61.80%,稍高于AC-THP组的50.90%(P>0.05)。治疗后,TcbHP组恶心,呕吐,腹泻,心脏毒性及手足综合征程度均显著低于AC-THP组(P<0.05);各肿瘤标志物[糖类抗原(CA19-9,CA125,CA153),癌胚抗原(CEA)]水平均显著低于AC-THP组(P<0.05);左心室射血分数(LVEF)及血清心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶MB(CK-MB)、氨基末端脑钠肽前体(NT-proBNP)水平均无明显变化(P>0.05),且均显著优于AC-THP组(P<0.05)。结论TcbHP方案治疗HER-2阳性乳腺癌的疗效与AC-THP方案相当,但前者降低肿瘤标志物生成的作用更明显,且心脏毒性风险相对更低。 展开更多
关键词 化学药物治疗 双靶向药物 新辅助治疗 人类表皮生长因子受体-2 乳腺癌 肿瘤标志物 心脏毒性
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我国医保谈判药品“双通道”管理政策执行困境及推进策略 被引量:1
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作者 李欣雨 徐娟 《中国药房》 CAS 北大核心 2024年第8期906-911,共6页
目的为我国医保谈判药品“双通道”管理政策的顺利实施落地提供参考。方法基于史密斯政策执行过程模型,从实施细则与监管体系、药品遴选、药品配备和质量控制、医保基金运行状况和信息化能力4个方面对医保谈判药品“双通道”政策的执行... 目的为我国医保谈判药品“双通道”管理政策的顺利实施落地提供参考。方法基于史密斯政策执行过程模型,从实施细则与监管体系、药品遴选、药品配备和质量控制、医保基金运行状况和信息化能力4个方面对医保谈判药品“双通道”政策的执行困境进行分析,并提出相应推进策略。结果与结论我国医保谈判药品“双通道”政策可能存在政策实施细则和全流程监管体系不够明确,部分医保谈判药品纳入“双通道”管理的适宜性和可操作性有待斟酌,药品配备和质量控制方面存在难点,各地医保基金管理和运行状况存在差异以及信息化能力不足等执行困境。对此,本研究认为可通过完善“双通道”政策实施细则、提高“双通道”药品目录合理性、建立“双通道”药店动态退出机制、推行专业化配送服务、完善电子处方流转平台等措施来推动“双通道”政策的实施落地。 展开更多
关键词 医保谈判药品 双通道 史密斯政策执行过程模型 电子处方流转 冷链运输
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癌症治疗中新型抗体偶联药物的研究进展
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作者 李雨凝 苏佳琳 +2 位作者 谭树华 罗永忠 张乐蒙 《中南大学学报(医学版)》 CAS CSCD 北大核心 2024年第2期296-304,共9页
传统抗体偶联药物(antibody drug conjugates,ADC)通过将单克隆抗体与细胞毒性药物相结合,实现对癌细胞的精准打击,但在稳定性、靶向性、疗效及安全性等方面依然存在诸多不足。新型ADC,如双特异性、位点特异性、双有效载荷和前药型ADC,... 传统抗体偶联药物(antibody drug conjugates,ADC)通过将单克隆抗体与细胞毒性药物相结合,实现对癌细胞的精准打击,但在稳定性、靶向性、疗效及安全性等方面依然存在诸多不足。新型ADC,如双特异性、位点特异性、双有效载荷和前药型ADC,通过同时结合2个不同抗原或表位、选择更稳定的连接子、与抗体特定氨基酸位点偶联、携带不同药物有效载荷以及采用前药策略等优化方法,在保留传统ADC作用特点的基础上,显著提高药物的稳定性、靶向性、疗效和安全性,能更好地满足临床治疗的需求。新型ADC可能会在未来的癌症治疗中发挥重要的作用。探讨新型ADC在癌症治疗中的进展并分析其优势与挑战,可为开发抗癌策略提供理论支持,为药物研发提供方向。 展开更多
关键词 抗体偶联药物 癌症 双特异性 位点特异性 双有效载荷 前药型
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“双通道”高值药品院内外使用特征及影响因素分析
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作者 苑顺 张乐 +2 位作者 杨莹 崔丹 毛宗福 《中国医疗保险》 2024年第5期16-25,共10页
目的:比较“双通道”管理机制下医疗机构门诊(院内)和零售药店(院外)两个渠道高值药品使用特征与变化趋势,探究高值药品院外用药行为的个体层面影响因素。方法:采集2019—2023年威海市全体参保人医保结算记录数据与相关政策文本,以五年... 目的:比较“双通道”管理机制下医疗机构门诊(院内)和零售药店(院外)两个渠道高值药品使用特征与变化趋势,探究高值药品院外用药行为的个体层面影响因素。方法:采集2019—2023年威海市全体参保人医保结算记录数据与相关政策文本,以五年间在医疗机构门诊或零售药店有过高值药品使用及报销记录的参保患者为研究对象,采用描述性统计分析方法,横向比较院内外两个渠道、纵向比较5个自然年度间用药人数、人次数、费用等指标差异;采用Heckman样本选择模型,从院外购药概率、院外用药比重两个方面量化院外用药行为,从个体特征、疾病特征、治疗特征三个维度开展影响因素分析。结果:2019—2023年间威海市高值药品用药人数、人次数、费用年均增幅分别为47.67%、78.72%、24.89%,其中,院外用药人数、人次数、费用年均增幅81.95%、135.77%、63.57%,相应占比亦逐年提升,于2023年达到87.41%、88.60%、88.05%。Heckman模型估计显示,与2019年相比,2020—2023年高值药品院外用药行为更为突出(P<0.01),四年来院外购药概率分别显著增加82.5%、149.5%、179.7%和169.9%。结论:“双通道”管理机制推动高值药品使用快速增长,处方外流趋势明显;患者院外用药行为存在显著年龄趋势,肿瘤类疾病、高药费负担、长用药周期、低院内用药次数等是患者高值药品院外用药行为的重要推动因素。 展开更多
关键词 “双通道”管理 高值药品 零售药店 院外用药行为 影响因素
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国家医保谈判药品“双通道”管理实施现状与政策分析
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作者 彭博 姜骁桐 +4 位作者 张小娟 叶媛 曹晓琳 刘阳 李亚子 《中国卫生政策研究》 CSCD 北大核心 2024年第5期9-16,共8页
目的:对最新版国家医保谈判药品“双通道”管理省级政策进行文本梳理和分析,对比各省份政策差异与创新举措,为完善“双通道”管理模式提供参考性建议。方法:检索2021年5月10日—2024年4月10日各省医疗保障局和卫生健康委等官方网站“双... 目的:对最新版国家医保谈判药品“双通道”管理省级政策进行文本梳理和分析,对比各省份政策差异与创新举措,为完善“双通道”管理模式提供参考性建议。方法:检索2021年5月10日—2024年4月10日各省医疗保障局和卫生健康委等官方网站“双通道”管理相关政策文件,采用内容分析法对文本资料进行提取和统计分析。结果:各省“双通道”管理政策在药品准入、医药机构遴选、待遇保障、用药管理和限制性政策调整等方面共性与差异性共存。结论:“双通道”政策设计应因地制宜,建议细化药品目录准入标准,规范设置医药机构准入门槛,科学确定医保待遇水平,制定差异化的用药认定管理方式,进一步削弱政策限制性因素。 展开更多
关键词 医保谈判药品 双通道管理 政策比较
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基于FAP基因启动子的心肌纤维化药物筛选系统的建立与验证
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作者 周驰 阚洪爽 +3 位作者 杨雅元 孟祥雯 欧阳昌汉 杨晓松 《中国药理学与毒理学杂志》 CAS 北大核心 2024年第3期194-199,共6页
目的建立以成纤维细胞激活蛋白(FAP)基因启动子为响应元件的新双荧光素酶报告基因系统建的心肌纤维化防治药物筛选方法。方法体外扩增小鼠FAP基因启动子片段,克隆至psiCHECK2质粒替换HSV-TK启动子,获得新的重组质粒psiCHECK2-FAP。重组... 目的建立以成纤维细胞激活蛋白(FAP)基因启动子为响应元件的新双荧光素酶报告基因系统建的心肌纤维化防治药物筛选方法。方法体外扩增小鼠FAP基因启动子片段,克隆至psiCHECK2质粒替换HSV-TK启动子,获得新的重组质粒psiCHECK2-FAP。重组质粒经限制性内切核酸酶HindⅢ消化后,进行琼脂糖凝胶电泳鉴定并纯化片段测序验证;将psiCHECK2-FAP瞬时转染至小鼠心肌成纤维细胞(MCF)培养24 h后,分别给予转化生长因子β1(TGF-β1)5μg·L^(-1),血管紧张素Ⅱ(AngⅡ)1μmol·L^(-1)或棕榈酸(PA)100μmol·L^(-1)处理0,12,24和48 h,双荧光素酶报告基因实验检测荧光素酶活性。将psiCHECK2-FAP瞬时转染至MCF细胞培养24 h后,达格列净(Dapa)1μmol·L^(-1)预处理1 h,再分别添加TGF-β1(5μg·L^(-1)),AngⅡ(1μmol·L^(-1))或PA(100μmol·L^(-1))处理24 h,双荧光素酶报告基因实验检测荧光素酶活性,Western印迹法检测MCF细胞中Ⅰ型胶原蛋白(ColⅠ)和ColⅢ的蛋白表达。结果HindⅢ将psiCHECK2-FAP切成2个片段且条带大小符合预期,测序结果与理论序列完全一致。与空白对照组相比,TGF-β1,AngⅡ和PA组均可显著增加MCF细胞中ColⅠ和ColⅢ表达(P<0.05,P<0.01);分别与TGF-β1,AngⅡ或PA组相比,Dapa干预后则显著降低ColⅠ和ColⅢ表达(P<0.05,P<0.01);与空白对照组相比,TGF-β1,AngⅡ或PA均可显著增加荧光素酶活性(P<0.05,P<0.01),24 h达最大值;分别与TGF-β1,AngⅡ或PA相比,Dapa干预后则显著降低荧光素酶活性(P<0.05,P<0.01)。结论以FAP基因启动子为响应元件的新双荧光素酶报告基因系统在MCF细胞中对促心肌纤维化因子表现出较好的敏感性,为心肌纤维化防治药物的研发提供策略。 展开更多
关键词 成纤维细胞活化蛋白 启动子 双荧光素酶报告系统 心肌纤维化 药物筛选
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国谈药单行支付政策研究
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作者 王宁锋 李雪竹 张慧 《卫生经济研究》 北大核心 2024年第6期16-18,共3页
为打通国谈药落地最后“一公里”,国家于2021年发文,提出对使用周期长、疗程费用高、替代性不强的国谈药实行单行支付政策。当前,各地的单行支付药品目录、管理方式和医保结算政策都存在一定差异,转乙类管理后的衔接政策不明。建议各地... 为打通国谈药落地最后“一公里”,国家于2021年发文,提出对使用周期长、疗程费用高、替代性不强的国谈药实行单行支付政策。当前,各地的单行支付药品目录、管理方式和医保结算政策都存在一定差异,转乙类管理后的衔接政策不明。建议各地加强政策协同,统一单行支付政策和管理方式,做好转乙类管理后的政策衔接工作,推动单行支付政策落地实施。 展开更多
关键词 双通道 国家谈判药品 医保单行支付
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医保谈判药品 双通道 管理机制政策文本分析
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作者 杨浩宇 王乾 田侃 《中国医疗管理科学》 2024年第3期13-19,共7页
目的分析国家层面“双通道”管理机制政策特征,为完善“双通道”管理机制政策提供参考。方法基于北大法宝数据库,检索并纳入8份与“双通道”管理机制相关的政策文件,基于政策工具和利益相关者构建二维分析框架,借助Excel并利用内容分析... 目的分析国家层面“双通道”管理机制政策特征,为完善“双通道”管理机制政策提供参考。方法基于北大法宝数据库,检索并纳入8份与“双通道”管理机制相关的政策文件,基于政策工具和利益相关者构建二维分析框架,借助Excel并利用内容分析法进行文本内容分析。结果政策制定者倾向于使用环境型政策工具;针对政府部门和医疗机构的政策工具使用相对均衡,各种政策工具均有涉及;针对定点药房,政策制定者使用的政策工具总量较少且种类相对单一。结论环境型政策工具的使用符合制度框架构建的政策定位,但仍需重视均衡各利益相关者的政策关注力度,探索发挥供给和需求型政策工具的保障和推动作用。 展开更多
关键词 医保谈判药品 “双通道”管理机制 政策工具 利益相关者
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替雷利珠联合化疗治疗非小细胞肺癌手术患者的效果
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作者 高薇薇 邵春艳 +2 位作者 姜洁 王欢 张磊 《中国药物应用与监测》 CAS 2024年第2期106-109,共4页
目的评价替雷利珠单抗在含铂双药化疗治疗的非小细胞肺癌手术患者中的应用效果。方法选取2022年1月—2023年12月收治的100例拟行手术治疗的非小细胞肺癌患者,根据随机数字表法将其分成两组。对照组50例患者在术前给予含铂双药治疗,观察... 目的评价替雷利珠单抗在含铂双药化疗治疗的非小细胞肺癌手术患者中的应用效果。方法选取2022年1月—2023年12月收治的100例拟行手术治疗的非小细胞肺癌患者,根据随机数字表法将其分成两组。对照组50例患者在术前给予含铂双药治疗,观察组50例患者在其治疗基础上加用替雷利珠单抗治疗。比较两组临床疗效、无事件及无疾病生存率、生活质量改善情况、不良反应。结果观察组临床疗效(完全缓解率:20.00%vs.10.00%)及病理评估(主要病理学缓解率:46.00%vs.20.00%)优于对照组(Z=3.484,P<0.001;χ^(2)=7.664,P=0.006);Kaplan-Meier生存分析显示,观察组无事件生存率(84.00%vs.60.00%)及无疾病生存率(78.00%vs.60.00%)均高于对照组(χ^(2)=4.298,P=0.038;χ^(2)=4.783,P=0.029);在生活质量改善率方面,观察组(64.00%)较对照组高(42.00%),差异有统计学意义(χ^(2)=4.857,P=0.028);两组不良反应发生率(18.00%vs.22.00%)比较,差异无统计学意义(χ^(2)=0.250,P=0.617)。结论在含铂双药化疗治疗非小细胞肺癌手术患者中的实施替雷利珠单抗治疗可提高治疗效果,促进生活质量改善,且不会增加不良反应发生风险。 展开更多
关键词 非小细胞肺癌 替雷利珠单抗 含铂双药 临床疗效 不良反应
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