阿米奥达龙和德罗纳达龙导致肝损伤,其临床表现明显不同
Alexander Pop1, Dina Halegoua-DeMarzio2, Huiman Barnhart3
1Albert Einstein Medical Center, Sidney Kimmel Medical College, Philadelphia, PA, USA.
Digestive diseases and sciences
|February 28, 2024
概括
阿米奥达龙诱导的肝损伤呈现出更长的潜伏期和脂肪变化,类似于与酒精有关的肝损伤. 德罗内达龙会导致较短时间的预测性肝损伤,突出明显的药物诱导的肝损伤机制.
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.
- 毒理学 毒理学 毒理学
背景情况:
- 阿米奥达龙和德龙达龙是抗心律失常药物,已知存在药物诱导性肝损伤 (DILI) 的风险.
- 了解这些相关药物的肝毒性独特模式对于患者管理至关重要.
研究的目的:
- 描述和比较amiodarone和dronedarone的肝毒性概况.
- 分析来自药物诱导肝损伤网络 (DILIN) 和美国食品和药物管理局 (FDA) 的不良事件报告系统 (FAERS) 的数据.
主要方法:
- 对DILIN病例 (2004-2020年) 和FAERS数据 (2009-2020年) 对阿米奥达龙和无人机引起的肝损伤的回顾性分析.
- 对临床表现,实验室值,肝活检发现和结果的审查.
主要成果:
- 与无人机 (119天,1191U/L) 相比,阿米奥达龙DILI的潜伏时间较长 (388天),在发病时ALT水平较低 (118U/L).
- 阿米奥达龙肝脏活检显示有纤维化,脂肪化和马洛里-克体. 德龙达龙DILI病例包括急性肝衰竭和需要肝移植的病例.
- 在amiodarone病例中发生了5例死亡 (一个是肝衰竭),在dronedarone病例中发生了1例死亡 (与肝脏无关).
结论:
- 阿米奥达龙的肝毒性类似于酒精性肝损伤,带有脂肪和炎症.
- 德罗纳达龙诱导的肝损伤是不太可预测的,具有较短的潜伏期,并且通常没有胆固醇症.
- 药理动力学差异可能导致阿米奥达龙和德龙达龙的肝毒性机制不同.
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