APT:功效升级!他汀类药物可降低胆管炎死亡风险

2018-04-18 佚名 生物探索

近日,一项在瑞典进行的大型研究发现,他汀类药物与原发性硬化性胆管炎(primary sclerosing cholangitis,PSC)患者的全因死亡率(all-cause mortality)、肝移植、肝癌和静脉曲张破裂出血风险显著降低相关。

越来越多的证据表明,他汀类药物对慢性肝病和胆汁淤积症患者有益。除了降低胆固醇之外,他汀类药物还能通过炎症、纤维化、内皮功能、血栓形成和凝血的不同多效性机制发挥有益作用,从而潜在地改善慢性肝病。不仅如此,这类药物与胆汁淤积性肝病患者中的胆汁淤积标记物的有益作用也相关。

最新研究

4月12日,法国巴黎举行的2018年国际肝病大会上公布了一项获奖研究。该研究评估了暴露于不同药物(包括他汀类、UDCA、氨基水杨酸盐、抗生素、硫唑嘌呤和糖皮质激素)对PSC患者各种临床结果的影响。

这项研究回顾了2005年至2016年间近2 914名PSC患者的记录。所有患者均患有克罗恩病溃疡性结肠炎(或两者兼有)。被纳入分析的患者中,74.4 %的人暴露于(exposed to)5 -氨基水杨酸,60.2 %的人暴露于UDCA,33.7 %的人暴露于硫唑嘌呤/巯基嘌呤,91%的人暴露于抗生素,12.1 %的人暴露于抗真菌药,34.2 %的人暴露于甲硝唑,69.3 %的人暴露于皮质类固醇,13.9 %的人暴露于他汀类药物(暴露被定义为从2005年后第一次分配药物到研究期结束的时间)。

“在我们的研究中,硫唑嘌呤和他汀类药物都与死亡、肝移植和静脉曲张破裂出血的风险降低有关,”介绍该成果的维斯比医院(Visby Hospital )和瑞典卡罗林斯卡研究所的 Knut Stokkeland博士说,“其中,他汀类药物与全因死亡率降低32%以及死亡或肝脏移植风险降低50%有关。”

重要意义

Stokkeland博士指出,这是对PSC中他汀类药物的第一次研究。他们认为,他汀类药物可能成为治疗PSC的、有希望的候选药物;然而,目前还没有足够的证据证明,可在PSC治疗中推荐常规使用这类药物。安全使用之前还需要在随机对照试验中进行进一步的评估。

“原发性硬化性胆管炎是一种仍然没有理想治疗方案的疾病。尽管分析注册记录不等同于临床试验,因此不能导致任何坚实的治疗建议,但它们对于了解疾病(尤其是罕见疾病,如PSC)的一般特征具有重要价值。这项研究为调查他汀类药物在PSC中的潜在疗效提供了可能,并有助于为今后的临床试验提供新的治疗途径。”意大利Ancona大学医院的Marco Marzioni教授和EASL理事会成员说。

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    2018-04-19 易水河

    知之为知之.

    0

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    2018-04-18 1e0f8808m18(暂无匿称)

    好文章.学习收获很大.

    0

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    2018-04-18 清风拂面

    谢谢分享学习

    0

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