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治疗非酒精性脂肪肝炎的米索普罗斯托尔:随机对照试验

Mehreen Siyal¹, Zaigham Abbas², Muhammad Ali Qadeer²

¹Department of Gastroenterology and Hepatology, Dr Ziauddin Hospital, Clifton Campus, Karachi, Pakistan drmehreensiyal@gmail.com.

BMJ open gastroenterology

|June 6, 2024

概括

与安慰剂相比,mizoprostol在非酒精性脂肪肝炎 (NASH) 患者中显示出改善的肝脂肪含量 (受控减弱参数). 虽然这两组都改善了肝功能测试,但mizoprostol并没有显著改变其他NASH标志物或胰岛素抵抗.

科学领域:

肝病学肝病学是一种肝病学.
胃肠病学胃肠病学
临床药理学临床药理学

背景情况:

非酒精性脂肪肝炎 (NASH) 是一个重要的未满足的临床需求.
作为前列腺素E1模拟剂的米索普罗斯托尔可以降低炎症性细胞因子,这表明NASH的治疗潜力.
这项研究研究了米索普罗斯托尔在NASH患者的疗效和安全性.

研究的目的:

评估米索普罗斯托尔在治疗非酒精性脂肪肝炎 (NASH) 的疗效.
评估NASH患者队列中mizoprostol的安全概况.
为了比较米索普罗斯托尔与安慰剂对肝功能和疾病标志物的影响.

主要方法:

一个第二阶段,双盲,随机,安慰剂对照试验.
50名NASH患者每天三次服用200微克米索普罗或安慰剂,持续2个月.
主要终点包括肝功能测试,IL-6和内毒素水平;次要终点包括胰岛素耐药性,失脂血症,纤维化和肉脂症.

主要成果:

与安慰剂相比,mizoprostol显著降低了受控减弱参数 (CAP) (p=0.039),表明肝脏肥胖症得到改善.
两组都显示出生化改善 (例如,ALT,AST),但没有统计学上显著的组间差异.
米索普罗斯托尔维持了稳定的IL-6和内毒素水平,而安慰剂显示IL-6增加 (p=0.049). 没有观察到胰岛素抵抗或纤维化的显著变化.

结论:

与NASH患者的安慰剂相比,mizoprostol在肝脏肥胖症 (CAP) 中显著改善.
在两组中都观察到生化改善,在mizoprostol和安慰剂之间没有统计学上显著的差异.
弥索普罗斯托尔的耐受性一般很好,腹是最常见的不良反应;没有发现严重的安全问题.

关键词:

末尾毒素 (Endotoxin) 是一种毒素.肝脏纤维化肝脏纤维化这就是INTERLEUKINS.没有酒精的状态肝炎.

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