アルツハイマー病の患者におけるタクリンの投与による肝毒性効果
P B Watkins1, H J Zimmerman, M J Knapp
1Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor.
JAMA
|April 6, 1994
まとめ
アルツハイマー病のタクリン治療は,特に女性の場合,肝臓酵素の上昇を引き起こす可能性があります. アラニンアミノトランスフェラーゼ (ALT) レベルを注意深くモニタリングすることで,潜在的な肝臓毒性の管理に役立ちます.
科学分野:
- 肝臓病理学 肝臓病理学
- 薬理学 薬理学とは
- 神経学 神経学とは
背景:
- アルツハイマー病は進行性神経変性障害である.
- タクリンは,アルツハイマー病に対する初期の薬剤介入でした.
- 肝臓への影響は,タクリンの治療で知られている懸念事項です.
研究 の 目的:
- アルツハイマー病患者におけるタクリンの肝臓効果を特徴づけるために.
- タクリン療法中の肝臓酵素値上昇の発生率と重症度を評価する.
- タクリンの投与を中止した後の肝毒性の可逆性を評価する.
主な方法:
- タクリンの複数の制御および濃縮設計の臨床試験からのデータの分析.
- 軽度から中等度のアルツハイマー病の成人患者2446人を含む.
- タクリンまたはプラセボを投与された患者の血清アラニンアミノトランスフェラゼ (ALT) レベルを毎週モニタリングする.
主要な成果:
- 49%の患者は,タクリンの治療中にALT値 (>ULN) の上昇を経験しました.
- 25%はALTレベル>3xULN,2%はALTレベル>20xULNでした.
- 増加は一般的に無症状で,女性ではより頻繁であり,中止時に回復し,88%が一時的な上昇後に治療を再開することができました.
結論:
- タクリンの治療は,ALT値上昇の有意な発生率と関連しています.
- ALTレベルを注意深くモニタリングすることは,タクリン誘発性肝毒性の管理に不可欠です.
- タクリンの潜在的利益は,注意深いモニタリングによってリスクと比較することができます.
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