Taking Care of Your Aorta 10/15/18 (Virtual Medical Symposium Series)
49:43-52:35
Q:
How about fluoroquinolones? What's somebody asked is that fluoroquinolones and the aorta. I know that's been in the news lately.
最近、フルオロキノロンと大動脈疾患との関連について騒がれていますが、詳しく教えて下さい。
A:
There have been at least two, if not, three large epidemiological sort of pharmacologic data- based surveys, which have linked aortic aneurysm in one and, I believe, the combination of aortic aneurysm and dissection in another with an increased risk of those events in someone who's taken a fluoroquinolone within the the year before, and some of them are, you know, within so many weeks, and some of them go up to a year. Now the this risk is, is, you know, is, let's say, it's a two-fold risk to a four-fold risk, something like that, let's say, it's a two-fold risk or something or, you know, an increased risk.
薬理学的データに基づく大規模な疫学調査の結果がいくつか報告されています。フルオロキノロンを服用した一部の患者さんが大動脈瘤や大動脈解離を発症したというものです。発症リスクは、はっきりとは述べられませんが、2～4倍ほど上昇したということです。
The absolute risk is still very, very small in these populations, but the relative risk is higher and so these aren't randomized, they're not controlled. They can't control for every other aspect like, you know, other risk factors because we don't know all the other risk factors in the individuals.
この集団での絶対リスクは非常に小さいのですが、相対リスクは高くなっています。これらの研究は無作為化されたものではなく、対照群を用いたものでもありません。個々の被験者のリスク因子については分からないので、それによる比較はできません。
So I think right now I'm intrigued as by this possibility because fluoroquinolones, the medicines like levofloxacin and ciprofloxacin, are associated with tendon rupture, so achilles tendon rupture, which is a collagen event can occur in individuals who take those medications, so there is something about it and the theory is that it impacts a matrix metalloproteinases which are enzymes which break down elastin and it affects those and so there is, a there is a theoretical background.
私はこのリスクに関心があります。というのは、フルオロキノロン（レボフロキサシン、シプロフロキサシンなど）は、アキレス腱のような腱の断裂と関連があるからです。腱断裂はフルオロキノロン系の薬を飲んでいる方に生じるコラーゲン関連のイベントです。そういった薬がMMP（マトリクスメタロプロテイナーゼ）と呼ばれるエラスチンを分解する酵素に影響を与えた結果、腱断裂が起きるという理論的な根拠があります。
And now the question is, is, is, it a clinical background and what do we do? So these agents are course very helpful in certain infections. So if someone has a infection that requires an antibiotic and this antibiotic is the number one choice, then you have to think about, "What are my alternatives?"
では、どうすればいいのかということになりますが、フルオロキノロン系の薬は特定の感染症には非常に効果があります。感染症を起こし抗菌剤の投与が必要で、フルオロキノロン系の薬が第一選択となる場合は、代替薬を考えなければなりません。
The FDA has not put any sort of warning on this, so we don't have anything like that at present. The Marfan Foundation professional board, I think, reviewed this when the FDA said. Well, at present we don't have any other information to make a blackbox warning or anything like that.
FDAはこれに関して現時点で警告を出していないので、我々としてはマルファン患者さんに対してお知らせできるものがありません。The Marfan Foundationの専門委員会がこのFDAの発表について精査したのではないかと思います。今の段階では、重大な注意喚起を行えるだけの情報がありません。
So I think I'm curious about this. I think, I think we are going to learn much more about it, but right now I think it's hypothesis-generating issue as opposed to something that's well established.
これから情報が出てくると思いますが、現時点では仮説であり、確実なものではありません。
And I think that that review by our professional advisory board is actually noted in the connective issues magazine that just came out, so that's on our website if people want to check that out.
私の方から補足です。これについては、機関紙『Connective Issues』で専門委員会の見解を載せていますので、ご覧ください。
The Marfan Foundation did not participate in the translation of these materials and does not in any way endorse them. If you are interested in this topic, please refer to our website, Marfan.org, for materials approved by our Professional Advisory Board.
The Marfan Foundation は、当翻訳には関与しておらず、翻訳内容に関してはいかなる承認も行っておりません。このトピックに興味をお持ちの方は、Marfan.orgにアクセスし、当協会の専門家から成る諮問委員会が承認した内容をご参照ください。
