Hydroxyurea compared with anagrelide in high-risk essential thrombocythemia
Hydroxyurea compared with anagrelide in high-risk essential thrombocythemia
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DOI：
10.1056/nejmoa043800
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发表时间：
2005-07-07
影响因子：
158.5
通讯作者：
Murray, M
中科院分区：
文献类型：
--
作者：
Harrison, CN;Campbell, PJ;Murray, M
背景：我们对羟基脲与阿那格雷治疗原发性血小板增多症进行了随机比较。方法：共有 809 名血管事件高危原发性血小板增多症患者接受小剂量阿司匹林联合阿那格雷或羟基脲治疗。复合主要终点是动脉血栓形成（心肌梗死、不稳定型心绞痛、脑血管意外、短暂性脑缺血发作或外周动脉血栓形成）、静脉血栓形成（深静脉血栓形成、内静脉血栓形成或肺栓塞）、严重出血或血栓或出血性死亡的精算风险。 结果：中位随访 39 个月后，阿那格雷组患者达到主要终点的可能性显着高于羟基脲组（比值比，1.57；95% 置信区间，1.04 至 2.37；P=0.03）。与羟基脲联合阿司匹林相比，阿那格雷联合阿司匹林与动脉血栓形成率增加(P=0.004)、严重出血(P=0.008)和转化为骨髓纤维化(P=0.01)有关，但静脉血栓栓塞发生率降低(P=0.006)。接受阿那格雷的患者更有可能退出指定的治疗（P
Background: We conducted a randomized comparison of hydroxyurea with anagrelide in the treatment of essential thrombocythemia.Methods: A total of 809 patients with essential thrombocythemia who were at high risk for vascular events received low-dose aspirin plus either anagrelide or hydroxyurea. The composite primary end point was the actuarial risk of arterial thrombosis (myocardial infarction, unstable angina, cerebrovascular accident, transient ischemic attack, or peripheral arterial thrombosis), venous thrombosis (deep-vein thrombosis, splanchnic-vein thrombosis, or pulmonary embolism), serious hemorrhage, or death from thrombotic or hemorrhagic causes.Results: After a median follow-up of 39 months, patients in the anagrelide group were significantly more likely than those in the hydroxyurea group to have reached the primary end point (odds ratio, 1.57; 95 percent confidence interval, 1.04 to 2.37; P=0.03). As compared with hydroxyurea plus aspirin, anagrelide plus aspirin was associated with increased rates of arterial thrombosis (P=0.004), serious hemorrhage (P=0.008), and transformation to myelofibrosis (P=0.01) but with a decreased rate of venous thromboembolism (P=0.006). Patients receiving anagrelide were more likely to withdraw from their assigned treatment (P