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Uso de pioglitazona a largo plazo en pacientes con DMAE: resultados de un estudio preliminar multicéntrico

Isabel Veloso Alves Pereira1, Ana Beatriz Souza de Oliveira1, Patricia Momoyo Yoshimura Zitelli1

  • 1Divisão de Gastroenterologia e Hepatologia, Hospital das Clínicas HCFMUSP (LIM-07), Departamento de Gastroenterologia e Nutrologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

Clinics (Sao Paulo, Brazil)
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PubMed
Resumen

El tratamiento a largo plazo con pioglitazona mejoró significativamente las enzimas hepáticas y la esteatosis en pacientes con enfermedad hepática esteática asociada a la disfunción metabólica (MASLD). Esto sugiere que la pioglitazona es una opción de tratamiento valiosa, especialmente cuando las alternativas son limitadas.

Palabras clave:
MáscarasEn el caso de losPioglitazona y sus derivados

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Área de la Ciencia:

  • Hepatología
  • Trastornos del metabolismo
  • Farmacología

Sus antecedentes:

  • La enfermedad hepática estatotica asociada a la disfunción metabólica (MASLD, por sus siglas en inglés) es un problema de salud creciente.
  • Los biomarcadores no invasivos son cruciales para evaluar la salud hepática en el MASLD.
  • Los efectos del tratamiento a largo plazo de la pioglitazona en la enfermedad requieren más investigación.

Objetivo del estudio:

  • Evaluar el impacto a largo plazo de la pioglitazona en la rigidez hepática, la esteatosis y otros biomarcadores no invasivos en pacientes con DMAE.
  • Evaluar la eficacia de la pioglitazona durante diferentes períodos de tratamiento (1 a 3 años frente a 4 a 10 años).

Principales métodos:

  • Estudio retrospectivo multicéntrico de 65 pacientes con DMAE tratados con pioglitazona (30-45 mg/ día).
  • Evaluación de la Elastografía Transiente Controlada por Vibración (VCTE), Parámetro de Atenuación Controlada (CAP) y puntuación FibroScan-AST antes y después del tratamiento.
  • Estratificación en dos grupos según la duración del tratamiento: 1 a 3 años y 4 a 10 años.

Principales resultados:

  • Se observaron reducciones significativas en la alanina aminotransferasa (ALT) y en la gamma glutamiltransferasa (GGT) en ambos grupos.
  • En el grupo de 4 a 10 años se observó una disminución significativa de la CAP, lo que indica una reducción de la esteatosis hepática.
  • La mejora en las puntuaciones FASTTM fue significativa en ambos grupos de duración del tratamiento.

Conclusiones:

  • El tratamiento a largo plazo con pioglitazona demuestra beneficios metabólicos y hepáticos significativos en pacientes con DMAE.
  • La pioglitazona muestra potencial como un tratamiento accesible y rentable para la enfermedad.
  • Los hallazgos apoyan el papel de la pioglitazona en el manejo de MASLD, particularmente en entornos con recursos limitados.