伊拉非布拉诺在初级胆管胆炎中的有效性和安全性
Kris V Kowdley1, Christopher L Bowlus1, Cynthia Levy1
1From Liver Institute Northwest, Seattle (K.V.K.); the Division of Gastroenterology and Hepatology, UC Davis School of Medicine, Sacramento (C.L.B.); Schiff Center for Liver Diseases, University of Miami, Miami (C.L.); the Department of Gastroenterology, Ege University Faculty of Medicine, İzmir, Turkey (U.S.A.); Gastroenterology and Hepatology Division, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (M.R.A.-S.); Medicina Interna Metabolica, Baggiovara Hospital, Azienda Ospedaliero-Universitaria di Modena and Università di Modena e Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology, Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, and the European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Fondazione IRCCS San Gerardo dei Tintori, Monza (P.I.) - all in Italy; Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago (M.A.), and Sección de Gastroenterología, Hospital San Juan de la Serena, Coquimbo (J.M. Valera) - both in Chile; the Reference Center for Inflammatory Biliary Disease and Autoimmune Hepatitis, European Reference Network RARE-LIVER, Saint-Antoine Hospital and Research Center, AP-HP, Sorbonne University, Paris (C.C.), GENFIT, Loos (J.-M.G., D.R., B.T.), and Ipsen, Boulogne-Billancourt (S.M.) - all in France; the Department of Gastroenterology and Hepatology, Antwerp University Hospital, and InflaMed Center of Excellence, Laboratory of Experimental Medicine and Paediatrics, Faculty of Medicine and Health Sciences, Antwerp University - both in Antwerp, Belgium (S.M.F.); the Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London (M.A.H.), the Institute of Cellular Medicine and NIHR Newcastle Biomedical Research Center, Newcastle University, Newcastle Upon Tyne (D.J.) - all in the United Kingdom; the Department of Gastroenterology and Hepatology, Mediclinic Durbanville, and Tiervlei Trial Centre - both in Cape Town, South Africa (F.C.K.); the Texas Liver Institute, University of Texas Health, San Antonio (E.L.), the Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas (M.J.M.), and the Departments of Medicine and Surgery, Baylor College of Medicine, Houston (J.M. Vierling) - all in Texas; the Liver Institute of Virginia, Bon Secours Mercy Health, Richmond (M.L.S.); the Liver Unit, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada (M.G.S.); Liver Unit, European Reference Network RARE-LIVER, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, CiberEhd, Barcelona (V.V.); Hepatic Autoimmunity Unit, Hospital Italiano de Buenos Aires, Buenos Aires (A.V.); GENFIT (C.A., J.D.) and Ipsen (B.M., J.S., C.O.Z.) - both in Cambridge, MA; and the Metabolic Liver Research Program, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, and the Department of Medicine II, Saarland University and Saarland University Medical Center, Homburg - both in Germany (J.M.S.).
伊拉非布拉诺在初级胆道胆炎患者中显著改善了胆化生化标志物. 这种双重PPAR激动剂为这种慢性肝病提供了有前途的治疗选择.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 初级胆道胆炎 (PBC) 是一种罕见的慢性胆固醇性肝病.
- PBC的特点是胆道的破坏,导致胆固醇和纤维化.
- 作为PPARα/δ激动剂的elafibranor对PBC的疗效正在研究中.
研究的目的:
- 评估elafibranor在治疗原发性胆道胆炎的疗效.
- 评估elafibranor对PBC患者生化标志物和的作用.
- 为了确定elafibranor在这个患者群体中的安全性概况.
主要方法:
- 一个跨国,第三阶段,双盲,安慰剂对照试验.
- 161名PBC患者对ursodeoxycholic酸反应不充分,被随机分配 (2:1) 每天服用elafibranor (80 mg) 或安慰剂,持续52周.
- 主要终点:生化反应 (性酸酶<1.67 ULN,≥15%的减少,正常的 bilirubin). 二级终点包括 (WI-NRS).
主要成果:
- 51%的elafibranor接受者实现了生化反应,而安慰剂组的这一比例为4% (P<0.001).
- 性酸酶在15%的elafibranor患者中正常化,而在安慰剂组中为0% (P=0.002).
- 两组之间没有观察到减少的显著差异.
结论:
- 与安慰剂相比,Elafibranor治疗导致胆固醇的生化指标显著改善.
- 埃拉非布拉诺显示出作为初级胆道胆炎的有效治疗潜力.
- 使用elafibranor的常见不良事件包括腹痛,腹,恶心和吐.
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