Short-Term Clinical Effects After Switching From Zinc Acetate Hydrate to Zinc Histidine Hydrate in Patients With...

Zinc deficiency is common in patients with chronic liver disease and is associated with hepatic encephalopathy, malnutrition, and poor prognosis. Zinc histidine hydrate was recently approved in Japan for the treatment of hypozincemia; however, clinical evidence regarding switching from zinc acetate hydrate remains limited. This study evaluated the short-term efficacy and safety of switching to zinc histidine hydrate in patients with chronic liver disease.

This single-center prospective single-arm switching study enrolled patients receiving zinc acetate hydrate. Patients were switched to zinc histidine hydrate at an equivalent elemental zinc dose. Serum zinc, ammonia, and copper levels were evaluated at 4 and 12 weeks. Appetite was assessed at baseline and 4 weeks using the Council on Nutrition Appetite Questionnaire Japanese version (CNAQ-J) and the Functional Assessment of Anorexia/Cachexia Therapy-Anorexia/Cachexia Subscale (FAACT A/CS).

Forty-two patients were switched to zinc histidine hydrate, and 40 were included in the analysis. The median serum zinc level increased significantly from 83 μg/dL at baseline to 101 μg/dL at 4 weeks (p = 0.0003) and remained significantly elevated at 96 μg/dL at 12 weeks (p = 0.0005). Serum ammonia and copper levels showed no significant changes. Appetite-related scores improved significantly after switching, with increases in CNAQ-J and FAACT A/CS scores at 4 weeks. No overt hepatic encephalopathy or clinically significant adverse events were observed.

Switching from zinc acetate hydrate to zinc histidine hydrate rapidly increased serum zinc levels and improved appetite. Zinc histidine hydrate may represent a practical option for optimizing zinc supplementation in patients with chronic liver disease.