基于证据的硅油填充眼玻璃体内注射药物剂量指南:药代动力学、安全性和最佳剂量。

IF 5.1 2区 医学 Q1 OPHTHALMOLOGY
Lorenzo Ferro Desideri, Peng Yong Sim, Enrico Bernardi, Karin Paschon, Janice Roth, Adrian T Fung, Xia Ni Wu, Hung-Da Chou, Robert Henderson, Edmund Tsui, Maria Berrocal, Jay Chhablani, Charles C Wykoff, Chui Ming Gemmy Cheung, Giuseppe Querques, Gustavo Barreto Melo, Yousif Subhi, Anat Loewenstein, Jens Folke Kiilgaard, Martin Zinkernagel, Rodrigo Anguita
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引用次数: 0

摘要

我们评估了硅油(SO)填充眼内玻璃体内药物的药代动力学、安全性和最佳剂量,以应对此类疗法的挑战。我们评估了硅油填充眼内玻璃体内药物的药理特性和安全性,并根据现有文献和专家共识得出结论和指导意见。临床前数据表明,抗血管内皮生长因子药物在SO填充眼内的半衰期相当,但临床证据主要来自病例报告和小型系列研究。现有研究优先考虑标准剂量,尤其是贝伐珠单抗(1.25 毫克),其证据比阿弗利贝赛普(2 毫克)或雷尼珠单抗(0.5 毫克)更充分。玻璃体内类固醇,尤其是 0.7 毫克的地塞米松,显示出有效性和安全性,而 0.19 毫克的氟西酮缩丙酮的证据有限。有报告称,250-400 微克剂量的玻璃体内甲氨蝶呤的主要预期副作用是角膜炎。病例报告显示,标准剂量的抗病毒药物(福斯卡尼 1.2-2.4 毫克/0.1 毫升、更昔洛韦 4 毫克/0.1 毫升)和抗生素复方哌拉西林/他唑巴坦(250 微克/0.1 毫升)均可耐受。总之,我们将根据目前有限的文献资料提供指导。应仔细考虑玻璃体内药物的标准剂量,同时密切监测潜在的副作用,并与患者进行讨论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evidence-based guidelines for drug dosing in intravitreal injections in silicone oil-filled eyes: Pharmacokinetics, safety, and optimal dosage.

We evaluate the pharmacokinetics, safety, and optimal dosages of intravitreal agents in silicone oil (SO)-filled eyes, addressing challenges in administering such therapies. We assessed the pharmacological properties and safety profiles of intravitreal drugs in SO-filled eyes, deriving conclusions and guidance from available literature and expert consensus. Preclinical data suggest comparable half-lives of anti-vascular endothelial growth factoragents in SO-filled eyes, but clinical evidence is mainly from case reports and small series. Available research prioritizes standard dosages, particularly for bevacizumab (1.25 mg), supported by stronger evidence than aflibercept (2 mg) or ranibizumab (0.5 mg). Intravitreal steroids, especially dexamethasone at 0.7 mg, show efficacy and safety, while evidence for fluocinolone acetonide at 0.19 mg is limited. Intravitreal methotrexate has been reported at the dosage of 250-400 μg, with keratitis as the primary expected side effect. Case reports indicate tolerability of standard dosages of antivirals (foscarnet 1.2-2.4 mg/0.1 mL, ganciclovir 4 mg/0.1 mL) and the antibiotic combination piperacillin/tazobactam (250 μg/0.1 mL). We offer guidance based on current, but limited, literature. Standard dosage of intravitreal agents should be carefully considered, along with close monitoring for potential side effects, which should be discussed with patients.

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来源期刊
Survey of ophthalmology
Survey of ophthalmology 医学-眼科学
CiteScore
10.30
自引率
2.00%
发文量
138
审稿时长
14.8 weeks
期刊介绍: Survey of Ophthalmology is a clinically oriented review journal designed to keep ophthalmologists up to date. Comprehensive major review articles, written by experts and stringently refereed, integrate the literature on subjects selected for their clinical importance. Survey also includes feature articles, section reviews, book reviews, and abstracts.
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