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Re-desafiar con niacina cristalina después de la hepatitis inducida por drogas de la niacina de liberación prolongada
Y Henkin1, K C Johnson, J P Segrest
1Department of Medicine, University of Alabama, Birmingham.
JAMA
|July 11, 1990
Resumen
La niacina de liberación sostenida es más hepatotóxica que la niacina cristalina. En un estudio, los pacientes con hepatitis de la niacina de liberación sostenida toleraron la niacina cristalina sin daño hepático, lo que sugiere que las formas cristalinas pueden ser más seguras.
Área de la Ciencia:
- Hepatología Hepatología.
- Farmacología Farmacología.
- Medicina interna es la medicina interna de las enfermedades.
Sus antecedentes:
- La niacina (ácido nicotínico) es una vitamina disponible en formulaciones cristalinas y de liberación sostenida (SR).
- La niacina SR se ha asociado con un aumento de la hepatotoxicidad en comparación con la niacina cristalina.
Objetivo del estudio:
- Para investigar la hepatotoxicidad comparativa de la niacina de liberación sostenida frente a la niacina cristalina.
- Para evaluar la seguridad de la niacina cristalina en pacientes que han sufrido lesiones hepáticas por niacina SR.
Principales métodos:
- Estudio de caso de tres pacientes con hepatitis durante el tratamiento con niacina SR.
- Desafíe con dosis equivalentes o más altas de niacina cristalina.
- Monitoreo de la evidencia de daño hepatocelular recurrente.
Principales resultados:
- Los pacientes toleraron el retorno de la niacina cristalina sin recurrencia del daño hepático.
- No se observó evidencia de lesión hepatocelular después de cambiar a la niacina cristalina.
Conclusiones:
- La niacina cristalina puede ser menos hepatotóxica que la niacina de liberación prolongada en ciertos pacientes.
- Estos hallazgos apoyan las observaciones anteriores sobre los diferentes perfiles de seguridad de las formulaciones de niacina.
- Se justifica una mayor investigación sobre el mecanismo de la hepatitis inducida por niacina.
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