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indometacin (IV) (Indocin IV)

✓ Approved

Merck & Co. · PTGS1 · 小分子

什么是 indometacin (IV)？

indometacin (IV) 是一种小分子，由Merck & Co.研发。该药已获批，用于治疗相关适应症，给药途径：Injectable (Others)、Intravenous (IV)。

药物档案

商品名Indocin IV
公司Merck & Co.
药物类别小分子
分子靶点PTGS1, PTGS2
给药途径Injectable (Others), Intravenous (IV)
状态Approved
来源： ClinicalTrials.gov, Merck & Co.

作用机制

分子靶点

indometacin (IV) 作用于 2 个分子靶点：

PTGS1prostaglandin-endoperoxide synthase 1 (COX3, PCOX1)
PTGS2prostaglandin-endoperoxide synthase 2 (GRIPGHS, hCox-2)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

indometacin (IV) 针对 1 个适应症，涉及 1 个治疗领域。

治疗领域疾病/病症分期
Congenital, familial and genetic disordersPatent ductus arteriosus✓ Approved

相关研究文献

PubMedFrontiers in oncology2026-09-10

Borrmann type IV gastric cancer exhibits distinct clinicopathological features and extremely poor prognosis.

Lin Qingyu Q, Li Zikang Z, Tang Wei W, Liu Jianqiu J et al.

Borrmann type IV gastric cancer (Bor-IV) is clinically recognized as an aggressive phenotype; however, its prognostic burden relative to contemporary TNM staging and its radiological correlates remain incompletely characterized. We retrospectively analyzed 1236 patients with advanced gastric adenocarcinoma who underwent radical gastrectomy, including 124 Bor-IV and 1112 Non Bor-IV cases. Clinicopathological features, multimodal imaging characteristics, and survival outcomes were compared. Overall survival (OS) and disease-free survival (DFS) were analyzed using Kaplan-Meier methods and Cox proportional hazards models. Among 1236 patients, 124 (10.03%) were Bor-IV and 1112 (89.97%) were Non Bor-IV. Bor-IV was associated with more advanced T stage, N stage, pathological stage, larger tumor size, and a higher proportion of signet-ring cell components (all p < 0.001). Multivariate Cox regression analysis confirmed Bor-IV as an independent prognostic factor for poor OS after adjusting for TNM and other clinicopathological factors (HR = 3.837, 95% CI: 2.900-5.080, P < 0.001). Patients with Bor-IV had a median OS of 21.3 months and a 5-year OS rate of 20.24%, significantly worse than Non Bor-IV across all pathological stages, T stages, and N stages. Notably, the survival of Bor-IV patients approached that of stage IV disease. In the Bor-IV subgroup, age > 60 years and advanced T stage were independent predictors of poor OS. Among treatment modalities, only R0 resection was significantly associated with improved DFS and OS. Bor-IV is characterized by distinctive imaging features and an exceptionally poor prognosis that is not fully captured by conventional TNM staging. Bor-IV may represent a clinically aggressive phenotype within advanced gastric cancer, underscoring the need for refined risk stratification and optimized multimodal treatment strategies in future prospective studies.

PMID 42718723
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PubMedTherapeutic advances in neurological disorders2026-09-10

Use of subcutaneous natalizumab in routine care - Final results of a non-interventional, observational study (SISTER) in Germany and Austria.

Gold Ralf R, Schmidt Stephan S, Deisenhammer Florian F, Motte Jeremias J et al.

Natalizumab is a disease-modifying therapy for patients with relapsing-remitting multiple sclerosis (RRMS). In addition to its original intravenous (IV) formulation, a subcutaneous (SC) route of administration (RoA) was approved in 2021. Subsequently, the observational SISTER study was initiated in Germany and Austria to generate real-world data on the utilization, patient preferences, safety, and effectiveness of natalizumab in everyday clinical practice. The primary objective was to compare patients' preference of RoA and satisfaction with SC vs. IV natalizumab at baseline and up to 12 months of treatment. Secondary objectives included drug utilization, effectiveness outcomes, safety, and treatment satisfaction with natalizumab. SISTER was a prospective, multicenter, observational study on RRMS patients who were allocated to 3 parallel treatment cohorts: Patients switching from IV to SC natalizumab (SC switcher) and patients starting natalizumab on either the SC or IV route (starter SC/IV). The final study analyses were based on 310 patients (220 switchers, 44 SC starters, 46 IV starters) with an observation period of 10.8±3.1 months. Patient preference for the initial RoA at baseline was 95.1% among SC starters and 77.5% among IV starters (p=0.045). More IV starters than SC starters or SC switchers at baseline and Month 6 wished to change the initial RoA. Disease activity remained low in all cohorts, and the AE pattern was consistent with the known safety profile of natalizumab. The procedure duration was distinctly shorter on SC treatment than on IV treatment. The final SISTER results suggest a patient preference for the SC vs. IV route and support the outcomes of the NOVA Part 2 trial, in which the preference of the SC route over IV was demonstrated in a cross-over design. The SC route allowed relevant time savings, and its good safety and tolerability argues for possible self-administration of SC natalizumab.

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PubMedPregnancy (Hoboken, N.J.)2026-09-10

Interventions following routine hemoglobin assessment after vaginal delivery.

Fujiwara Sarah S, Siu Andrea A, Yamasato Kelly K

To assess the utility of routine postpartum hemoglobin (Hgb) testing after vaginal delivery with normal blood loss by evaluating the frequency of blood transfusion and intravenous (IV) iron administration. This retrospective cohort study included vaginal deliveries with blood loss <500 mL at a tertiary hospital between January 2020 and May 2025. Patients with missing blood loss data, preeclampsia/eclampsia, or a hemorrhage diagnosis were excluded. Predelivery and postpartum Hgb values, as well as blood transfusion and IV iron administration, were collected. The primary outcomes were postpartum blood transfusion and IV iron administration. Univariate logistic regression was used to identify variables associated with blood transfusion and IV iron administration. Multivariable logistic regression was then performed to evaluate independent predictors of each outcome. Manual chart review was performed for those who received a blood transfusion or IV iron to identify signs of anemia and relevant comorbidities. Of 21,719 vaginal deliveries, 11,180 were included. Of these, 10,075 (90.1%) underwent postpartum Hgb testing with a mean Hgb decrease of 1.3 g/dL (SD, 0.9) pre- to postdelivery. Among the 11,180 deliveries, 19 (0.2%) received blood transfusion, and 82 (0.7%) received IV iron. Higher predelivery Hgb was associated with lower odds of blood transfusion (odds ratio [OR], 0.27; 95% confidence interval [CI], 0.19-0.38) and IV iron administration (OR, 0.25; 95% CI, 0.20-0.30). Among the 10,954 deliveries with predelivery Hgb ≥9 g/dL, six (0.05%) received blood transfusion. Of these six patients, five had anemia symptoms (n = 1) or comorbidities, including sepsis (n = 2) and vaginal hematoma (n = 2). Thirty-nine patients with a predelivery Hgb ≥9 g/dL received IV iron, of whom 13 (33.3%) had anemia symptoms and/or comorbidities. Among patients with predelivery Hgb ≥9 g/dL, normal blood loss, and no symptoms or comorbidities, the probability of receiving a blood transfusion or IV iron was 0.23% (one blood transfusion and 26 IV iron infusions). Applying a predelivery Hgb threshold of ≥9 g/dL to guide selective postpartum testing would have avoided 98% of routine assessments while maintaining 99.8% sensitivity for identifying patients who received a blood transfusion or IV iron. In this large cohort of vaginal deliveries with normal blood loss, blood transfusion and IV iron administration were rare. Selective postpartum Hgb testing based on predelivery Hgb and symptoms or comorbidities can be considered.

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PubMedFrontiers in pharmacology2026-09-10

Dynamic remodeling of the tumor immune microenvironment: immunometabolic regulatory networks of astragalus polysaccharides and astragaloside IV.

Xu Ziming Z, Wang Lijie L, Zhang Xin X, Qi Yue Y

The highly heterogeneous tumor immune microenvironment (TIME) remains a major obstacle to effective cancer immunotherapy. This review systematically elucidates the immunometabolic regulatory networks of the primary active constituents of Astragalus membranaceus-Astragalus polysaccharides (APS) and Astragaloside IV (AS-IV)-within the TIME. Synthesizing preclinical evidence up to January 2026, we focus on immune cell modulation, metabolic interventions, and advanced translational strategies. Evidence indicates that APS and AS-IV modulate the TIME through two primary mechanisms: regulating cellular immunity (APS facilitates dendritic cell maturation and attenuates T-cell exhaustion, while AS-IV promotes an immunostimulatory M1 macrophage polarization) and modulating tumor bioenergetics (inhibiting aerobic glycolysis and lipid metabolism to alleviate resource competition). Furthermore, experimental models demonstrate that co-delivering these agents via advanced nanoplatforms or in combination with immune checkpoint inhibitors significantly enhances anti-tumor responses. Ultimately, APS and AS-IV exhibit promising potential to shift the TIME from an immunosuppressive state toward an immunostimulatory microenvironment, highlighting their potential transition from empirical adjuvants to rationally designed precision immunotherapies.

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Comparative outcomes for tirzepatide versus glucagon-like peptide-1 receptor agonists in patients with inflammatory bowel disease: a national propensity matched study.

Patel Krishan S KS, Fakhoury Butros B, Parmar Kavin K, Jahagirdar Vinay V et al.

Evidence suggests glucagon-like peptide-1 receptor agonists (GLP-1RAs) may improve disease-specific outcomes for inflammatory bowel disease (IBD). Tirzepatide, a dual GLP-1 and glucose-dependent insulinotropic polypeptide receptor agonist, may offer additional benefits. We compared clinical and safety outcomes among patients with IBD treated with tirzepatide versus GLP-1RAs. Patients aged ≥ 18 years with IBD were identified within a retrospective multiinstitutional U.S. database who were prescribed tirzepatide or GLP-1RA between May 2022 and January 2025. Propensity score matching (1:1) was performed for demographics, comorbidities, and IBD medications. Outcomes were assessed over 18 months and included intravenous (IV) steroid use, intestinal surgery, emergency department visits, hospitalization, and a composite of IV steroids and surgery. Adverse outcomes were assessed. After matching, 3,042 patients (mean age, 54.6 years; 71.3% female) were analyzed in each cohort. Median follow-up was 540 days (interquartile range, 478-540 days) for tirzepatide versus 540 days (interquartile range, 540-540 days) for GLP-1RA. Patients taking tirzepatide had a significantly reduced risk of IV steroid use (adjusted hazard ratio [aHR], 0.81; 95% confidence interval [CI], 0.68-0.94) and composite IBD outcomes (aHR, 0.86; 95% CI, 0.73-0.97) with similar risk of hospitalization, emergency department visit and receipt of intestinal surgery. In patients with ulcerative colitis specifically, tirzepatide was similarly associated with a reduced risk of IV steroid use (aHR, 0.82; 95% CI, 0.69-0.97). Adverse outcome risks were similar. Patients with IBD prescribed tirzepatide may have lower risk of IV steroid use compared to those taking GLP-1RAs. Prospective studies are warranted to validate these results and explore underlying mechanisms.

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PubMedFrontiers in digital health2026-09-10

Clinical temporal relation extraction with long-context transformers: a robustness study on MIMIC-III and MIMIC-IV.

Padmavathi Polisetty Swetha V SV, Godavarthi Deepthi D

Temporal relation extraction from electronic health records is important for patient timeline construction and longitudinal clinical analysis, yet remains challenging because temporally relevant evidence may be distributed across extended clinical narratives. This study investigated whether long-context clinical transformers offer practical advantages for rule-based event-pair temporal relation classification across matched and transfer-oriented evaluation settings. Event-pair datasets were constructed from MIMIC-III and MIMIC-IV discharge summaries, with temporal labels assigned using a deterministic rule-based pipeline. The task was formulated as a four-class classification problem using BEFORE, AFTER, OVERLAP, and NONE labels. Clinical-Longformer and Clinical-BigBird were evaluated as primary long-context models, while BERT-base, BioBERT, Bio_ClinicalBERT and BiomedBERT served as standard-context baselines. To address GPU memory constraints during 4,096-token fine-tuning, a progressive two-stage strategy was used, in which long-context models were first fine-tuned at 1,024 tokens and then continued at 4,096 tokens. Experiments covered in-domain, zero-shot inter-dataset, and adaptation-based transfer settings. Clinical-BigBird achieved the best MIMIC-III in-domain macro-F1 of 93.85% and the strongest performance in both adaptation settings. Clinical-Longformer achieved the best MIMIC-IV in-domain macro-F1 of 97.32% and the strongest zero-shot MIMIC-IV-to-MIMIC-III macro-F1 of 92.36%. BERT-base and BioBERT reproduced the same directional transfer pattern, with stronger MIMIC-III-to-MIMIC-IV zero-shot results and improvements after adaptation. The 4,096-token continuation stage consistently outperformed 1,024-token training alone. Physician review confirmed 160 of 200 rule-derived labels as correct, corresponding to 80.0% agreement. Statistical testing supported selected improvements, although not all pairwise differences were significant. Long-context modeling was particularly useful for improving robustness to dataset shift and target-domain adaptation in clinical temporal relation extraction. However, the findings should be interpreted in the context of rule-derived silver labels.

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