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Impact of cachexia and opioid analgesic co-treatment on pregabalin pharmacokinetics and central nervous system symptoms in cancer patients
http://hdl.handle.net/10271/00003750
http://hdl.handle.net/10271/00003750f5b7caac-0511-44a1-841d-399e85462bf9
| 名前 / ファイル | ライセンス | アクション |
|---|---|---|
論文本文 (823.1 kB)
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| Item type | 学位論文 / Thesis or Dissertation(1) | |||||||
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| 公開日 | 2020-11-06 | |||||||
| タイトル | ||||||||
| タイトル | Impact of cachexia and opioid analgesic co-treatment on pregabalin pharmacokinetics and central nervous system symptoms in cancer patients | |||||||
| 言語 | en | |||||||
| 言語 | ||||||||
| 言語 | eng | |||||||
| キーワード | ||||||||
| 主題 | pregabalin | |||||||
| キーワード | ||||||||
| 主題 | central nervous system (CNS) symptoms | |||||||
| キーワード | ||||||||
| 主題 | plasma concentrations | |||||||
| キーワード | ||||||||
| 主題 | cancer cachexia | |||||||
| キーワード | ||||||||
| 主題 | opioid analgesics | |||||||
| 資源タイプ | ||||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_db06 | |||||||
| 資源タイプ | doctoral thesis | |||||||
| アクセス権 | ||||||||
| アクセス権 | open access | |||||||
| アクセス権URI | http://purl.org/coar/access_right/c_abf2 | |||||||
| その他のタイトル | ||||||||
| その他のタイトル | がん患者におけるプレガバリンの薬物動態と中枢神経症状に対する悪液質とオピオイド鎮痛薬併用の影響 | |||||||
| 著者 |
吉川, 望美
× 吉川, 望美
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| 書誌情報 |
en : Therapeutic drug monitoring 巻 41, 号 5, p. 591-597, 発行日 2019-10 |
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| 出版者 | ||||||||
| 出版者 | Lippincott Williams & Wilkins | |||||||
| 言語 | en | |||||||
| 抄録 | ||||||||
| 内容記述タイプ | Abstract | |||||||
| 内容記述 | BACKGROUND: Cancer patients receiving pregabalin potentially have a high incidence of central nervous system (CNS) symptoms. The purpose of this study was to explore clinical factors influencing the incidence of CNS symptoms, including plasma pregabalin exposure, cancer cachexia, and opioid analgesic co-treatment. METHODS: Sixty-eight cancer patients receiving twice-daily pregabalin were enrolled. Plasma concentrations of pregabalin, clinical laboratory data, opioid analgesic co-treatment, and the Glasgow Prognostic Score (GPS), which is an inflammation-based cachexia score, were considered as clinical factors. The incidence of CNS symptoms was collected from the patients’ medical records. The pre-dose plasma concentrations of pregabalin at steady-state was determined by ultra-high-performance liquid chromatography. RESULTS: The steady-state trough plasma pregabalin concentrations showed a large variability with an interquartile range of 0.43-1.2 mg/L per mg/kg and was negatively correlated with estimated glomerular filtration rate (eGFR). C-reactive protein (standardized partial regression coefficient, β=0.31) and opioid analgesic co-treatment (β=0.24) were also identified in addition to eGFR (β=-0.60) in the multiple regression analysis. The incidence of CNS symptoms was significantly increased with opioid analgesic co-treatment and a higher GPS but not with the absolute value of plasma pregabalin concentrations, eGFR, nor other clinical laboratory data. CONCLUSIONS: In cancer patients, steady-state trough plasma pregabalin concentrations were altered with renal function, systemic inflammation, and opioid analgesic co-treatment. However, a higher incidence of CNS symptoms observed in cancer patients on pregabalin was more related to cachexia and opioid analgesic co-treatment than to altered pregabalin concentrations. |
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| 言語 | en | |||||||
| 学位名 | ||||||||
| 学位名 | 博士（医学） | |||||||
| 学位の区分 | ||||||||
| 内容記述 | doctoral | |||||||
| 学位の分野 | ||||||||
| 内容記述 | 医学系研究科 | |||||||
| 学位授与機関 | ||||||||
| 学位授与機関識別子Scheme | kakenhi | |||||||
| 学位授与機関識別子 | 13802 | |||||||
| 学位授与機関名 | 浜松医科大学 | |||||||
| 学位授与年月日 | ||||||||
| 学位授与年月日 | 2020-03-16 | |||||||
| 学位授与番号 | ||||||||
| 学位授与番号 | 甲第825号 | |||||||
| ISSN | ||||||||
| 収録物識別子タイプ | EISSN | |||||||
| 収録物識別子 | 0163-4356 | |||||||
| EISSN | ||||||||
| 収録物識別子タイプ | PISSN | |||||||
| 収録物識別子 | 1536-3694 | |||||||
| PubMed番号 | ||||||||
| 識別子タイプ | PMID | |||||||
| 関連識別子 | 30986807 | |||||||
| 出版社DOI | ||||||||
| 識別子タイプ | DOI | |||||||
| 関連識別子 | https://doi.org/10.1097/FTD.0000000000000634 | |||||||
| 著者版フラグ | ||||||||
| 出版タイプ | AM | |||||||
| 出版タイプResource | http://purl.org/coar/version/c_ab4af688f83e57aa | |||||||
