{"id":13037,"date":"2023-12-18T15:31:07","date_gmt":"2023-12-18T07:31:07","guid":{"rendered":"https:\/\/docquity.com\/?post_type=articles&p=13037"},"modified":"2025-02-11T13:38:24","modified_gmt":"2025-02-11T05:38:24","slug":"diem-tin-hoi-nghi-aha-2023-kha-nang-giam-bien-co-xuat-huyet-an-tuong-cua-thuoc-khang-dong-uc-che-yeu-to-xi","status":"publish","type":"articles","link":"https:\/\/docquity.com\/vi\/articles\/diem-tin-hoi-nghi-aha-2023-kha-nang-giam-bien-co-xuat-huyet-an-tuong-cua-thuoc-khang-dong-uc-che-yeu-to-xi\/","title":{"rendered":"\u0110i\u1ec3m tin h\u1ed9i ngh\u1ecb AHA 2023: Kh\u1ea3 n\u0103ng gi\u1ea3m bi\u1ebfn c\u1ed1 xu\u1ea5t huy\u1ebft \u1ea5n t\u01b0\u1ee3ng c\u1ee7a thu\u1ed1c kh\u00e1ng \u0111\u00f4ng \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 XI"},"content":{"rendered":"\n

Ch\u00fang t\u00f4i \u0111\u00e3 gi\u1edbi thi\u1ec7u v\u1edbi b\u1ea1n \u0111\u1ecdc v\u1ec1 tri\u1ec3n v\u1ecdng thu\u1ed1c kh\u00e1ng \u0111\u00f4ng \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 XI tr\u00ean b\u1ec7nh nh\u00e2n rung nh\u0129 c\u00f3 nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 trung b\u00ecnh cao. \u0110\u1ebfn nay, kh\u1ea3 n\u0103ng l\u00e0m gi\u1ea3m bi\u1ebfn c\u1ed1 xu\u1ea5t huy\u1ebft c\u1ee7a thu\u1ed1c kh\u00e1ng \u0111\u00f4ng \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 XI kh\u00f4ng ch\u1ec9 n\u1eb1m \u1edf m\u1ee9c tri\u1ec3n v\u1ecdng, m\u00e0 \u0111\u00e3 \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh th\u00f4ng qua b\u1eb1ng ch\u1ee9ng m\u1edbi. V\u00e0o th\u00e1ng 11 v\u1eeba qua, b\u1eb1ng ch\u1ee9ng m\u1edbi n\u00e0y – k\u1ebft qu\u1ea3 th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng pha 2b c\u1ee7a ch\u1ea5t kh\u00e1ng \u0111\u00f4ng \u1ee9c ch\u1ebf y\u00eau t\u1ed1 XI (AZALEA-TIMI 71) \u0111\u00e3 \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 t\u1ea1i H\u1ed9i ngh\u1ecb Th\u01b0\u1eddng ni\u00ean c\u1ee7a Hi\u1ec7p h\u1ed9i Tim m\u1ea1ch Hoa K\u1ef3 (AHA) 2023. B\u00e1o c\u00e1o \u0111\u00e3 cho th\u1ea5y t\u00ednh an to\u00e0n v\u01b0\u1ee3t tr\u1ed9i c\u1ee7a ch\u1ea5t \u1ee9c ch\u1ebft y\u1ebfu t\u1ed1 XI. B\u00e0i vi\u1ebft t\u00f3m t\u1eaft b\u1eb1ng ch\u1ee9ng m\u1edbi n\u00e0y \u0111\u1ebfn b\u1ea1n \u0111\u1ecdc [1].<\/p>\n\n\n\n

Click \u0111\u1ec3 tham kh\u1ea3o ngay b\u00e0i vi\u1ebft \u201cCh\u1ea5t \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 XI: H\u1ee9a h\u1eb9n cho l\u1ef1a ch\u1ecdn kh\u00e1ng \u0111\u00f4ng an to\u00e0n?<\/a>\u201d<\/p>\n\n\n\n

T\u00f3m t\u1eaft phi\u00ean b\u00e1o c\u00e1o k\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u AZALEA \u2013 TIMI 71<\/strong><\/p>\n\n\n\n

Thu\u1ed1c kh\u00e1ng \u0111\u00f4ng \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 XI<\/em><\/strong><\/p>\n\n\n\n

Y\u1ebfu t\u1ed1 XI v\u1eeba quan tr\u1ecdng trong qu\u00e1 tr\u00ecnh \u0111\u00f4ng m\u00e1u nh\u01b0ng l\u1ea1i kh\u00f4ng c\u00f3 vai tr\u00f2 c\u1ed1t y\u1ebfu trong kh\u1ea3 n\u0103ng s\u1eeda ch\u1eefa m\u1ea1ch m\u00e1u. Y\u1ebfu t\u1ed1 XI \u0111\u01b0\u1ee3c cho l\u00e0 c\u00f3 th\u1ec3 ng\u0103n ch\u1eb7n s\u1ef1 h\u00ecnh th\u00e0nh c\u1ee5c m\u00e1u \u0111\u00f4ng trong khi v\u1eabn cho ph\u00e9p qu\u00e1 tr\u00ecnh c\u1ea7m m\u00e1u x\u1ea3y ra \u0111\u1ec3 ph\u00f2ng ng\u1eeba xu\u1ea5t huy\u1ebft. M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u quan s\u00e1t c\u0169ng cho th\u1ea5y r\u1eb1ng b\u1ec7nh nh\u00e2n thi\u1ebfu h\u1ee5t y\u1ebfu t\u1ed1 XI c\u00f3 t\u1ef7 l\u1ec7 \u0111\u1ed9t qu\u1ef5 v\u00e0 nh\u1ed3i m\u00e1u c\u01a1 tim th\u1ea5p nh\u01b0ng kh\u00f4ng c\u00f3 t\u00ecnh tr\u1ea1ng xu\u1ea5t huy\u1ebft t\u1ef1 ph\u00e1t. Ch\u00ednh v\u00ec v\u1eady, \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 XI \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ed9t nh\u00f3m thu\u1ed1c c\u00f3 tri\u1ec3n v\u1ecdng [2].<\/p>\n\n\n\n

Th\u1eed nghi\u1ec7m AZALEA<\/em><\/strong><\/p>\n\n\n\n

Th\u1eed nghi\u1ec7m AZALEA \u0111\u01b0\u1ee3c cho l\u00e0 th\u1eed nghi\u1ec7m c\u00f3 quy m\u00f4 l\u1edbn nh\u1ea5t c\u1ee7a c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 XI cho t\u1edbi nay, bao g\u1ed3m 1287 b\u1ec7nh nh\u00e2n v\u1edbi th\u1eddi gian theo d\u00f5i trung v\u1ecb l\u00e0 2 n\u0103m (h\u00ecnh 1). Nghi\u00ean c\u1ee9u AZALEA \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh tr\u00ean b\u1ec7nh nh\u00e2n rung nh\u0129 c\u00f3 nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 trung b\u00ecnh \u2013 cao. B\u1ec7nh nh\u00e2n tham gia nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c ph\u00e2n ng\u1eabu nhi\u00ean theo t\u1ef7 l\u1ec7 1:1:1 v\u00e0o 3 nh\u00f3m: (i) abelacimab li\u1ec1u 150 mg \u0111\u01b0\u1eddng ti\u00eam d\u01b0\u1edbi da x 1 l\u1ea7n\/th\u00e1ng; (ii) abelacimab li\u1ec1u 90 mg \u0111\u01b0\u1eddng ti\u00eam d\u01b0\u1edbi da x 1 l\u1ea7n\/th\u00e1ng v\u00e0 (iii) rivaroxaban 20 mg\/ng\u00e0y. K\u1ebft c\u1ee5c ch\u00ednh c\u1ee7a nghi\u00ean c\u1ee9u l\u00e0 ti\u00eau ch\u00ed an to\u00e0n \u0111\u00e1nh gi\u00e1 d\u1ef1a tr\u00ean c\u00e1c bi\u1ebfn c\u1ed1 xu\u1ea5t huy\u1ebft nghi\u00eam tr\u1ecdng ho\u1eb7c kh\u00f4ng nghi\u00eam tr\u1ecdng li\u00ean quan v\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng [3].<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

H\u00ecnh 1.<\/strong> Thi\u1ebft k\u1ebf nghi\u00ean c\u1ee9u th\u1eed nghi\u1ec7m AZALEA \u2013 TIMI 71<\/p>\n\n\n\n

K\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u<\/em><\/strong><\/p>\n\n\n\n

K\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u cho th\u1ea5y abelacimab l\u00e0m gi\u1ea3m c\u00f3 \u00fd ngh\u0129a bi\u1ebfn c\u1ed1 xu\u1ea5t huy\u1ebft nghi\u00eam tr\u1ecdng v\u00e0 kh\u00f4ng nghi\u00eam tr\u1ecdng li\u00ean quan v\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng so v\u1edbi rivaroxaban \u1edf b\u1ec7nh nh\u00e2n rung nh\u0129 (b\u1ea3ng 1). Abelacimab li\u1ec1u 15 mg l\u00e0m gi\u1ea3m 67% nguy c\u01a1 c\u1ee7a c\u00e1c bi\u1ebfn c\u1ed1 xu\u1ea5t huy\u1ebft nghi\u00eam tr\u1ecdng v\u00e0 kh\u00f4ng nghi\u00eam trong li\u00ean quan v\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng. B\u1ec7nh nh\u00e2n nh\u00f3m \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng abelacimab c\u00f3 t\u1ef7 l\u1ec7 m\u1eafc c\u00e1c bi\u1ebft c\u1ed1 xu\u1ea5t huy\u1ebft nghi\u00eam tr\u1ecdng n\u00f3i chung gi\u1ea3m 74% v\u00e0 c\u00e1 bi\u1ebfn c\u1ed1 xu\u1ea5t huy\u1ebft nghi\u00eam tr\u1ecdng tr\u00ean \u0111\u01b0\u1eddng ti\u00eau h\u00f3a n\u00f3i ri\u00eang gi\u1ea3m 93%. Xu\u1ea5t huy\u1ebft \u0111\u01b0\u1eddng ti\u00eau h\u00f3a l\u00e0 m\u1ed9t trong nh\u1eefng m\u1ed1i lo ng\u1ea1i l\u1edbn \u1edf b\u1ec7nh nh\u00e2n rung nh\u0129 khi \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng kh\u00e1ng \u0111\u00f4ng. V\u1edbi k\u1ebft qu\u1ea3 c\u1ee7a th\u1eed nghi\u1ec7m AZALEA, abelacimab \u0111\u00e3 cho th\u1ea5y t\u00ednh an to\u00e0n v\u01b0\u1ee3t tr\u1ed9i \u1edf b\u1ec7nh nh\u00e2n rung nh\u0129, gi\u1ea3m b\u1edbt m\u1ed1i lo ng\u1ea1i v\u1ec1 bi\u1ebfn c\u1ed1 xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a \u1edf b\u1ec7nh nh\u00e2n rung nh\u0129 [1, 4].<\/p>\n\n\n\n

B\u1ea3ng 1.<\/strong> K\u1ebft c\u1ee5c xu\u1ea5t huy\u1ebft<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Khi so s\u00e1nh v\u1ec1 kh\u1ea3 n\u0103ng l\u00e0m gi\u1ea3m nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 (hi\u1ec7u l\u1ef1c) c\u1ee7a abelacimab v\u00e0 rivaroxaban, v\u1ec1 m\u1eb7t con s\u1ed1, t\u1ef7 l\u1ec7 m\u1eafc \u0111\u1ed9t qu\u1ef5 cao h\u01a1n \u1edf nh\u00f3m \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi abelacimab (li\u1ec1u 90 mg v\u00e0 150 mg) so v\u1edbi rivaroxaban (b\u1ea3ng 2). Tuy nhi\u00ean, v\u00ec t\u1ef7 l\u1ec7 m\u1eafc \u0111\u1ed9t qu\u1ef5 trong th\u1eddi gian theo d\u00f5i l\u00e0 qu\u00e1 th\u1ea5p \u2013 25 tr\u01b0\u1eddng h\u1ee3p t\u1ed5ng c\u1ed9ng \u1edf c\u1ea3 3 nh\u00f3m nghi\u00ean c\u1ee9u, s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 kh\u1ea3 n\u0103ng l\u00e0m gi\u1ea3m nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 c\u1ee7a abelacimab so v\u1edbi rivaroxaban v\u1eabn ch\u01b0a th\u1ec3 so s\u00e1nh [1, 4].<\/p>\n\n\n\n

B\u1ea3ng 2.<\/strong> Hi\u1ec7u l\u1ef1c l\u00e0m gi\u1ea3m kh\u1ea3 n\u0103ng \u0111\u1ed9t qu\u1ef5<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

\u0110\u1ec3 \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c hi\u1ec7u l\u1ef1c ph\u00f2ng ng\u1eeba \u0111\u1ed9t qu\u1ef5 c\u1ee7a ch\u1ea5t \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 XI, c\u1ea7n c\u00f3 c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng pha 3. Th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng pha 3 \u0111\u00e1nh gi\u00e1 hi\u1ec7u l\u1ef1c c\u1ee7a ch\u1ea5t \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 XI v\u1eabn \u0111ang \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh.<\/p>\n\n\n\n

C\u01a1 ch\u1ebf c\u1ee7a y\u1ebfu t\u1ed1 XI<\/strong><\/p>\n\n\n\n

C\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 XI \u0111\u01b0\u1ee3c cho l\u00e0 c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m c\u00e1c bi\u1ebfn c\u1ed1 huy\u1ebft kh\u1ed1i nh\u01b0ng kh\u00f4ng g\u00e2y ra xu\u1ea5t huy\u1ebft qu\u00e1 m\u1ee9c v\u00ec y\u1ebfu t\u1ed1 XI tham gia v\u00e0o qu\u00e1 tr\u00ecnh h\u00ecnh th\u00e0nh c\u1ee5c m\u00e1u \u0111\u00f4ng, g\u00e2y t\u1eafc ngh\u1ebdn \u0111\u1ed9ng m\u1ea1ch, d\u1eabn \u0111\u1ebfn \u0111\u1ed9t qu\u1ef5 v\u00e0 nh\u1ed3i m\u00e1u c\u01a1 tim nh\u01b0ng y\u1ebfu t\u1ed1 XI l\u1ea1i kh\u00f4ng tham gia v\u00e0o qu\u00e1 tr\u00ecnh ch\u1eefa l\u00e0nh m\u1ea1ch m\u00e1u sau ch\u1ea5n th\u01b0\u01a1ng [1, 4].<\/p>\n\n\n\n

B\u00e0n lu\u1eadn<\/strong><\/p>\n\n\n\n

AZALEA l\u00e0 th\u1eed nghi\u1ec7m \u0111\u1ed1i \u0111\u1ea7u \u0111\u1ea7u ti\u00ean gi\u1eefa ch\u1ea5t \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 XI v\u00e0 DOAC trong th\u1eddi gian d\u00e0i theo d\u00f5i, th\u1eed nghi\u1ec7m \u0111\u00e3 \u0111\u01b0\u1ee3c k\u1ebft th\u00fac s\u1edbm v\u00ec l\u1ee3i \u00edch r\u00f5 r\u1ec7t c\u1ee7a abelacimab so v\u1edbi rivaroxaban. V\u1edbi k\u1ebft qu\u1ea3 c\u1ee7a th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng AZALEA pha 2b, ch\u1ea5t \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 XI m\u1edf ra hy v\u1ecdng v\u1ec1 m\u1ed9t ch\u1ea5t kh\u00e1ng \u0111\u00f4ng an to\u00e0n. Hi\u1ec7u l\u1ef1c ph\u00f2ng ng\u1eeba \u0111\u1ed9t qu\u1ef5 c\u1ee7a ch\u1ea5t \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 XI v\u1eabn ch\u01b0a th\u1ec3 \u0111\u01b0\u1ee3c ngo\u1ea1i suy t\u1eeb d\u1eef li\u1ec7u c\u1ee7a th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng pha 2b. \u0110\u1ed9i ng\u0169 ch\u00fang t\u00f4i s\u1ebd c\u1eadp nh\u1eadt \u0111\u1ebfn b\u1ea1n \u0111\u1ecdc khi k\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 trong th\u1eddi gian t\u1edbi.<\/p>\n\n\n\n

T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/p>\n\n\n\n

    \n
  1. American Heart Association. Late-Breaking & Featured Science – Professional Heart Daily AZALEA-TIMI 71 \u2013 Abelacimab, a Novel Factor XI\/XIa Inhibitor, vs Rivaroxaban in Patients with Atrial Fibrillation: Primary Results of the AZALEA-TIMI 71 Randomized Trial.<\/li>\n\n\n\n
  2. TIMI STUDY GROUP. AZALEA-TIMI 71. Accessed date 1 Oct 2023. URL: https:\/\/timi.org\/azalea-timi- 71\/<\/a><\/li>\n\n\n\n
  3. Sue Hughes. Factor XI Inhibitors: The Promise of a Truly Safe Anticoagulant? Medscape. Updated 28 Sep 202 Accessed date 29 Sep 2023. URL: https:\/\/www.medscape.com\/viewarticle\/996923?src=<\/li>\n\n\n\n
  4. Sue Hughes. Impressive Bleeding Profile With Factor XI Inhibitor in AF: AZALEA. Medscape. Updated 13 Nov 2023. Accessed date 05 Dec 2023. URL: https:\/\/www.medscape.com\/viewarticle\/998418#vp_2<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Ch\u00fang t\u00f4i \u0111\u00e3 gi\u1edbi thi\u1ec7u v\u1edbi b\u1ea1n \u0111\u1ecdc v\u1ec1 tri\u1ec3n v\u1ecdng thu\u1ed1c kh\u00e1ng \u0111\u00f4ng \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 XI tr\u00ean b\u1ec7nh nh\u00e2n rung nh\u0129 c\u00f3 nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 trung b\u00ecnh cao. \u0110\u1ebfn nay, kh\u1ea3 n\u0103ng l\u00e0m gi\u1ea3m bi\u1ebfn c\u1ed1 xu\u1ea5t huy\u1ebft c\u1ee7a thu\u1ed1c kh\u00e1ng \u0111\u00f4ng \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 XI kh\u00f4ng ch\u1ec9 n\u1eb1m \u1edf …<\/p>\n

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