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肝胆相照论坛 论坛 学术讨论& HBV English 他汀类药物:老药作为肝病的新疗法?
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他汀类药物:老药作为肝病的新疗法? [复制链接]

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发表于 2018-12-15 17:55 |只看该作者 |倒序浏览 |打印
Clinical Trial Watch
Statins: Old drugs as new therapy for liver diseases?
Author links open overlay panelElisaPose12JonelTrebicka4567Rajeshwar PMookerjee8PaoloAngeli9PereGinès123
https://doi.org/10.1016/j.jhep.2018.07.019
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Summary

In addition to lowering cholesterol levels, statins have pleiotropic effects, particularly anti-inflammatory, antiangiogenic, and antifibrotic, that may be beneficial in some chronic inflammatory conditions. Statins have only recently been investigated as a potential treatment option in chronic liver diseases because of concerns related to their safety in patients with impaired liver function. A number of experimental studies in animal models of liver diseases have shown that statins decrease hepatic inflammation, fibrogenesis and portal pressure. In addition, retrospective cohort studies in large populations of patients with cirrhosis and pre-cirrhotic conditions have shown that treatment with statins, with the purpose of decreasing high cholesterol levels, was associated with a reduced risk of disease progression, hepatic decompensation, hepatocellular carcinoma development, and death. These beneficial effects persisted after adjustment for disease severity and other potential confounders. Finally, a few randomised controlled trials have shown that treatment with simvastatin decreases portal pressure (two studies) and mortality (one study). Statin treatment was generally well tolerated but a few patients developed severe side effects, particularly rhabdomyolysis. Despite these promising beneficial effects, further randomised controlled trials in large series of patients with hard clinical endpoints should be performed before statins can be recommended for use in clinical practice.


Keywords
Statins
Pleiotropic effects
Chronic liver diseases
Decompensation
Portal hypertension

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发表于 2018-12-15 17:56 |只看该作者
临床试验观察
他汀类药物:老药作为肝病的新疗法?
作者链接open overlay panelElisaPose12JonelTrebicka4567RajeshwarPMookerjee8PaoloAngeli9PereGinès123
https://doi.org/10.1016/j.jhep.2018.07.019
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摘要

除降低胆固醇水平外,他汀类药物具有多效性,特别是抗炎,抗血管生成和抗纤维化,这在某些慢性炎症状态下可能是有益的。他汀类药物最近才被研究作为慢性肝病的潜在治疗选择,因为他们担心肝功能受损患者的安全性。在肝病动物模型中的许多实验研究表明他汀类药物可减少肝脏炎症,纤维发生和门静脉压力。此外,对大量肝硬化和肝硬化前病人的回顾性队列研究表明,用降低高胆固醇水平的他汀类药物治疗可降低疾病进展,肝功能失代偿,肝细胞癌发展的风险。和死亡。在调整疾病严重程度和其他潜在的混杂因素后,这些有益效果持续存在。最后,一些随机对照试验表明,辛伐他汀治疗可降低门静脉压力(两项研究)和死亡率(一项研究)。他汀类药物治疗一般耐受性良好,但少数患者出现严重的副作用,特别是横纹肌溶解症。尽管有这些有希望的有益效果,但在推荐将他汀类药物用于临床实践之前,应该对具有严格临床终点的大量患者进行进一步的随机对照试验。

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关键词
他汀类药物
多效性
慢性肝病
失代偿
门脉高压症

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发表于 2018-12-15 17:56 |只看该作者

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