<International Circulation>: So there were a lot of trial results presented at this meeting and a few of them had neutral results such as AIM-HIGH. What can we learn from these negative or neutral results from clinical trials? Is it more important to get a positive result?
《国际循环》:因此此次会议上报告可很多试验结果,有一些得到了中立的结果,比如AIM-HIGH。从这些阴性或中立的结果的临床试验中 ,我们能知道什么?得到阳性结果是不是更重要?
Prof Antman:As clinicians we have important questions that can really only be answered when you do a properly designed and sized and conducted clinical trial. Surely it is dramatic and exciting and is going to change practice when we find a dramatic positive result but we also believe that it is extremely important to report the results of all trials even those that prove to be neutral or harmful. I gave you the example of the PALLAS study with dronedarone. Here is a drug that is actually on the market and can be prescribed right now. What I have learned from this presentation is that I would never want to prescribe that drug now to a patient with permanent atrial fibrillation. It was extremely important to have that report here as well.
Antman教授: 作为临床医生,实际上只有当合理地设计、限定其规模并且正确地执行临床实验时,我们才能得到答案。当然当我们发现一个明显的结果是非常引人注目、令人振奋的,可能改变临床事件,但是我们还相信如实地报道临床试验即使被证实的是中立或者有害的结果是极其重要的。我给你举个PALLAS研究中决奈达隆的例子。这里有一个实际上市场上存在的药物,并且现在就可以开具处方。我从报告中得知的内容是我将来不会想去给永久性房颤的病人开具给药。同样有这个报告极其重要。
<International Circulation>: In the SATURN trial, high doses of two potent statins were shown to promote atherosclerotic regression, were well tolerated and with few clinical adverse events. How do you think these results will affect daily practice? Clinicians, in the past, have been reluctant to use high doses of statins largely due to safety concerns.
《国际循环》: 在SATURN试验中,两个高剂量的强效的他汀类药物被证明可以促进动脉粥样硬化的逆转,它们的耐受性很好,并且临床负性事件极少。您认为这些结果是如何影响日常的医疗实践的?过去的临床医生一直不愿意使用高剂量的他汀类药物主要是因为其安全方面的考虑。
Prof Antman: The SATURN trial told us that these high doses of statins were well-tolerated and that’s good news for clinicians who need to care for patients with elevated cholesterol levels and particularly LDLc. So we have yet another set of data saying that it is important to stay on these drugs and it is safe to do so. Many patients are reluctant to take medications such as statins about which they may have heard some bad things from other sources many of which are inaccurate. Both of these powerful statins, atorvastatin and rosuvastatin, were well-tolerated and I hope that armed with this information we will see clinicians feeling more comfortable prescribing the high doses of statins that we know translate into improved outcomes in our patients.
Antman教授: SATURN研究告诉我们这些高剂量的他汀类药物耐受性很好,这对临床医生来说好消息,它们需要关注患者升高的胆固醇水平尤其是LDL-c。因此我们有一组数据说坚持应用上述药物非常重要,而且这样做是安全的。许多患者因为通过其他来源(许多是不正确的)听说了他汀类药物的不良事件而不愿意服用他汀类等药物。这些强效的阿托伐他汀、瑞伐他汀等他汀类药物耐受性良好,我希望通过这些信息能让我们看到临床医生开具这些高剂量的他汀类药物时感觉更舒适,而这些药物据我们所知可以在患者身上看到结果的明显改善。