甲巯咪唑和丙基硫氧嘧啶治疗患者粒细胞减少症的发生率与剂量有关

IF 1.3 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Endocrine journal Pub Date : 2024-05-03 DOI:10.1507/endocrj.ej24-0135
Jaeduk Yoshimura Noh, Kosuke Inoue, Nami Suzuki, Ai Yoshihara, Miho Fukushita, Masako Matsumoto, Hideyuki Imai, Shigenori Hiruma, Masahiro Ichikawa, Masakazu Koshibu, Akiko Sankoda, Rei Hirose, Natsuko Watanabe, Kiminori Sugino, Koichi Ito
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引用次数: 0

摘要

粒细胞减少症是甲巯咪唑(MMI)和丙基硫尿嘧啶(PTU)的一种严重不良反应,虽然有报告显示这两种药物的发生率与剂量有关,但证据并不确凿。我们的研究目的是确定 MMI 和 PTU 引起的粒细胞减少症的发生率是否与剂量有关。研究对象是27784名未经治疗的巴塞杜氏病患者,其中22993人接受过90天以上的抗甲状腺药物治疗。在这个子集中,18259 名患者接受过 MMI 治疗,4734 名患者接受过 PTU 治疗。根据剂量的不同,MMI 组粒细胞减少症的发生率为:10 毫克/天 0.13%,15 毫克/天 0.20%,20 毫克/天 0.32%,30 毫克/天 0.47%,显示出显著的剂量依赖性。在 PTU 组中,当剂量为 125 毫克/天及以下时,粒细胞减少的病例为 0 例;当剂量为 150 毫克/天时,为 0.33%;当剂量为 200 毫克/天时,为 0.31%;当剂量为 300 毫克/天时,为 0.81%。MMI 15 毫克和 PTU 300 毫克时,即在抑制激素合成的效力相同时,粒细胞减少的发生率分别为 0.20% 和 0.81%,PTU 组明显更高。我们的研究结果证实,两种药物都会增加粒细胞减少症的发生率,但在甲状腺激素合成抑制剂量相当的情况下,PTU诱发粒细胞减少症的倾向要比MMI高得多。
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Dose-dependent incidence of agranulocytosis in patients treated with methimazole and propylthiouracil

Agranulocytosis is a serious adverse effect of methimazole (MMI) and propylthiouracil (PTU), and although there have been reports suggesting a dose-dependent incidence in relation to both drugs, the evidence has not been conclusive. The objective of our study was to determine whether the incidences of agranulocytosis induced by MMI and PTU exhibit dose-dependency. The subjects were 27,784 patients with untreated Graves’ disease, 22,993 of whom were on an antithyroid drug treatment regimen for more than 90 days. Within this subset, 18,259 patients had been treated with MMI, and 4,734 had been treated with PTU. The incidence of agranulocytosis according to dose in the MMI group was 0.13% at 10 mg/day, 0.20% at 15 mg/day, 0.32% at 20 mg/day, and 0.47% at 30 mg/day, revealing a significant dose-dependent increase. In the PTU group, there were 0 cases of agranulocytosis at doses of 125 mg/day and below, 0.33% at 150 mg/day, 0.31% at 200 mg/day, and 0.81% at 300 mg/day, also revealing a significant dose-dependent increase. The incidence of agranulocytosis at MMI 15 mg and PTU 300 mg, i.e., at the same potency in terms of hormone synthesis inhibition, was 0.20% and 0.81%, respectively, and significantly higher in the PTU group. Our findings confirm a dose-dependent increase in the incidence of agranulocytosis with both drugs, but that at comparable thyroid hormone synthesis inhibitory doses PTU has a considerably higher propensity to induce agranulocytosis than MMI does.

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来源期刊
Endocrine journal
Endocrine journal 医学-内分泌学与代谢
CiteScore
4.30
自引率
5.00%
发文量
224
审稿时长
1.5 months
期刊介绍: Endocrine Journal is an open access, peer-reviewed online journal with a long history. This journal publishes peer-reviewed research articles in multifaceted fields of basic, translational and clinical endocrinology. Endocrine Journal provides a chance to exchange your ideas, concepts and scientific observations in any area of recent endocrinology. Manuscripts may be submitted as Original Articles, Notes, Rapid Communications or Review Articles. We have a rapid reviewing and editorial decision system and pay a special attention to our quick, truly scientific and frequently-citable publication. Please go through the link for author guideline.
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