一个随机,双盲,安慰剂对照的阿尔达费明试验在NASH和补偿性肝硬化患者中进行
Mary E Rinella1, Hsiao D Lieu2, Kris V Kowdley3,4
1University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA.
Hepatology (Baltimore, Md.)
|September 21, 2023
概括
阿尔达费明显著降低了NASH肝硬化补偿患者的肝纤维化. 这种FGF19模拟剂在改善肝脏健康方面表现有前途,3mg剂量显示出最大的益处.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 非酒精性脂肪肝炎 (NASH) 肝硬化与补偿性肝功能呈现出未满足的治疗需求.
- 现有的治疗方法在这个特定的患者群体中缺乏经过证明的疗效.
- 阿尔达费明是一种工程 FGF19 模拟物,已显示出在非循环性 NASH 中的潜力.
研究的目的:
- 评估阿尔达费尔明在NASH补偿性肝硬化患者中的疗效和安全性.
- 为了确定阿尔达费尔明治疗这种疾病的最佳剂量.
主要方法:
- 一个多中心,双盲,安慰剂控制的2b期试验,涉及160名患者.
- 随机对待阿尔达费尔明 (0.3毫克,1毫克,3毫克) 或安慰剂48周.
- 主要终点:从基线到第48周,增强性肝纤维化 (ELF) 评分的变化.
主要成果:
- 3毫克的阿尔达费尔明显著降低了ELF得分 (-0.5差异与安慰剂相比,p=0.0003).
- 纤维化改善 (≥1阶段) 在接受3毫克阿尔达费尔明治疗的患者中被观察到23%,与安慰剂治疗的15%相比.
- 肝酶 (ALT,AST),原标记物和肝硬度的改善有利于阿尔达费林.
- 腹是最常见的不良事件;由于不良事件而中止治疗的几率很低 (3毫克的治疗量为9%).
结论:
- 3毫克的阿尔达费明剂量显著减少了NASH肝硬化补偿患者的肝纤维化.
- 这项研究支持阿尔达费明作为这种患者群体的潜在治疗选择.
- 需要进一步研究长期疗效和安全性.
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