How effective is the treatment with Micatrio from Boehringer Ingelheim, Japan? Is there anything to pay attention to when patients stop taking medication?
Micatrio has shown significant clinical efficacy in the treatment of cystic fibrosis, and its discontinuation should follow standardized procedures to avoid disease recurrence.
1. Therapeutic effect
(1) Improvement of lung function
Treatment for 24 weeks can increase FEV1 by an average of 14.3%, reduce the risk of acute pulmonary exacerbations by 63%, and maintain stable efficacy until 48 weeks.
(2) Changes in biochemical indicators
The average concentration of chloride in sweat decreased by 41.8mmol/L, and 90% of patients reached below the diagnostic threshold, significantly improving electrolyte balance.
(3) Improvement of quality of life
The CFQ-R respiratory score increased by 20.2 points, the average body mass index increased by 1.3 kg/m ², and the patient's nutritional status improved significantly.
2. Precautions for discontinuation of medication
(1) Planned discontinuation of medication
It is recommended to gradually reduce the dosage under the guidance of a doctor to avoid sudden withdrawal of medication causing symptoms to rebound. The recommended reduction period is no less than 4 weeks.
(2) Unplanned discontinuation treatment
If the missed dose exceeds 6 hours, it must be supplemented according to specific rules: if the morning dose is missed, it can be supplemented on the same day, but the evening dose will be skipped. If the evening dose is missed, it will be skipped directly.
(3) Monitoring after discontinuation of medication
Continuous monitoring of lung function, nutritional indicators, and sweat chloride concentration is required for at least 3 months to be alert for signs of worsening of the condition.
(4) Discontinue medication for special populations
Patients with abnormal liver function need to extend ALT/AST monitoring to 6 months after discontinuing medication; Pregnant patients still need to track fetal development after discontinuing medication.
3. Drug interactions
(1) High risk interactions
Strong CYP3A4 inducers such as rifampicin and phenobarbital can reduce the blood concentration of this drug by up to 70%, and should be avoided in combination or the dosage adjusted; Strong CYP3A4 inhibitors such as ketoconazole may increase the risk of adverse reactions.
(2) Medium risk interaction
Moderate acting CYP3A4 inhibitors such as clarithromycin and erythromycin should be used cautiously in combination; Herbal preparations such as St. John's wort may weaken their efficacy, and it is recommended to take them at intervals of more than 12 hours.
(3) Special precautions
Proton pump inhibitors may affect the absorption of Tezakaford, and it is recommended to stagger the administration time; Hormonal contraceptives may have reduced efficacy and require non pharmacological contraceptive measures.
Disclaimer：《How effective is the treatment with Micatrio from Boehringer Ingelheim, Japan? Is there anything to pay attention to when patients stop taking medication?》Edited and sorted by Seagull Pharmacy's editors. Please contact us in time if there is any infringement. In addition, the suggestions for drug usage, dosage and disease mentioned in the article are only for medical staff's reference, and can not be used as any basis for medication！