J Hepatology:NGM282(FGF19类似物)在原发性硬化性胆管炎中的作用

2019-02-17 不详 MedSci原创

原发性硬化性胆管炎(PSC)是一种炎症性,胆汁淤积性和逐渐纤维化的肝脏疾病,目前还缺乏有效的治疗方案,而NGM282是一种工程化的非致瘤性FGF19类似物,能够有效调节CYP7A1介导的胆汁酸稳态。因此,本项研究的主要目的是评估患有PSC的患者使用NGM282后的治疗效果。

背景与目的
原发性硬化性胆管炎(PSC)是一种炎症性,胆汁淤积性和逐渐纤维化的肝脏疾病,目前还缺乏有效的治疗方案,而NGM282是一种工程化的非致瘤性FGF19类似物,能够有效调节CYP7A1介导的胆汁酸稳态。因此,本项研究的主要目的是评估患有PSC的患者使用NGM282后的治疗效果。

方法
本项研究纳入了62例通过胆道造影或活检证实存在PSC并且碱性磷酸酶升高1.5倍以上的患者,所有患者按随机分配1:1:1接受NGM282 1 mg,3 mg或安慰剂治疗,每日一次,共12周。主要观察结果是ALP水平从基线到第12周的变化情况。次要和探索性结果包括胆汁酸代谢和纤维化的血清生物标志物的变化。

结果
结果显示在12周时,NGM282组和安慰剂组患者之间ALP与基线的平均变化没有显着差异。然而,NGM282药物显着降低了7α-羟基-4-胆甾烯-3-酮水平(肝CYP7A1活性的标志物)(95%CI :10.7至-1.7; p = 0.008)。预测无移植存活的纤维化生物标志物,包括增强型肝纤维化评分和Pro-C3在NGM282治疗后显着改善。同时NGM282治疗组的患者肠道症状更为频繁。

结论
在PSC患者中,NGM282能够有效抑制胆汁酸合成并减少纤维化标志物,而不显着影响ALP水平。

原始出处:

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    2020-01-27 xinxin088
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    2019-02-19 gwc384
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