加巴喷丁类药物个体化治疗带状疱疹后神经痛的研究进展*

The Research Progress of Individualized Therapy of Gabapentinoids in Patients with Postherpetic Neuralgia

摘要:

加巴喷丁类药物(主要包括加巴喷丁和普瑞巴林)是带状疱疹后神经痛的一线治疗药物,临床应用广泛。加巴喷丁类药物的体内药动学过程受肾功能影响较大,多数研究表明加巴喷丁和普瑞巴林的体内清除与肾小球滤过率具有显著相关性,因此肾功能减退患者和老年患者需酌情减量使用。加巴喷丁类药物体内过程存在较大个体差异,导致个体差异的原因目前尚无定论。因此,本文将对影响加巴喷丁类药物药动学和药效学变化的因素、个体差异产生的可能原因进行分析和综述,结合加巴喷丁类药物的治疗药物监测(Therapeutic drug monitoring, TDM)和基因多态性检测手段,为带状疱疹后神经痛患者的个体化、精准化治疗提供依据。

Abstract:

Gabapentinoid (mainly including gabapentin and pregabalin) are first-line therapeutic drugs with postherpetic neuralgia, and the clinical applications are widely used. The clinical application is greatly affected by renal function. Most studies have shown that the removal of gabapentin and pregabalin has a significant correlation with glomerular filtration rate. Therefore, patients with renal dysfunction and elderly patients should use it in moderation. There are significant individual differences in the internal processes of gabapentinoid drug, and the reasons for these individual differences are currently inconclusive. Therefore, we will analyze and review the factors that affect the pharmacokinetic and pharmacological changes of gabapentinoid drug, as well as the possible reasons for individual differences. Combined with the serum therapeutic drug monitoring (TDM) and genetic testing methods of gabapentinoid drug, it will provide a basis for personalized and precise treatment of patients with postherpetic neuralgia.