Circadian Variation in Efficacy of Medications.
Circadian Variation in Efficacy of Medications.
复制标题
药物疗效的昼夜节律变化。
DOI：
10.1002/cpt.2073
复制
发表时间：
2021-06
影响因子：
6.7
通讯作者：
Nelson RJ
中科院分区：
文献类型：
--
作者：
Walton JC;Walker WH 2nd;Bumgarner JR;Meléndez-Fernández OH;Liu JA;Hughes HL;Kaper AL;Nelson RJ
尽管在过去的几十年里，人们对生物钟和节律有了很多了解，但将生理和行为时间调节的基础科学转化为临床应用的速度一直很慢。事实上，人们对现代生物节律研究的接受度已经减弱，因为周期性变化的现象学必须与世纪生物科学和医学中的内稳态教条相抗衡。我们正在提供临床数据的审查，以强调医生，临床医生和药剂师对药物疗效的昼夜变化的认识。我们建议应进行金标准双盲临床研究，以确定一天中最佳的时间，以获得最佳的药物效果;此外，我们建议在以后进行的临床研究中，应跟踪并报告一天中的时间，作为一个重要的生物学变量。此外，我们强调，在研究设计中，一天中的时间是一个关键的生物学变量，应该被考虑，类似于性别。与历史上强烈偏向男性的生物医学研究数据一样，大多数药物数据都偏向于早晨给药，没有强有力的证据表明这是最佳疗效时间。
Although much has been learned about circadian clocks and rhythms over the past few decades, translation of this foundational science underlying the temporal regulation of physiology and behavior to clinical applications has been slow. Indeed, acceptance of the modern study of circadian rhythms has been blunted because the phenomenology of cyclic changes had to counteract the 20th century dogma of homeostasis in the biological sciences and medicine. We are providing this review of clinical data to highlight the emerging awareness of circadian variation in efficacy of medications for physicians, clinicians, and pharmacists. We are suggesting that gold-standard double-blind clinical studies should be conducted to determine the best time of day for optimal effectiveness of medications; also, we suggest that time of day should be tracked and reported as an important biological variable in ongoing clinical studies hereafter. Furthermore, we emphasize that time of day is, and should be considered, a key biological variable in research design similar to sex. In common with biomedical research data that have been historically strongly skewed towards males, most pharmaceutical data have been skewed towards morning dosing without strong evidence that this is the optimal time of efficacy.
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