长期使用胆固醇与发生性肝硬化有关:现实世界队列研究
Mohammad E Naffaa1,2, Fadi Hassan1,2, Helana Jeries1,2
1Rheumatology Unit, Galilee Medical Center, Nahariya, Israel.
Scandinavian journal of gastroenterology
|March 6, 2025
概括
长期使用胆固醇与患肝硬化,特别是不补偿性肝硬化风险的增加有关. 这表明将其使用限制在家庭地中海热 (FMF) 等没有替代品存在的疾病中.
科学领域:
- 肝病学和胃肠病学 肝病学和胃肠学
- 药理学和治疗学 药理学和治疗学
- 临床研究 临床研究
背景情况:
- 常用于治疗痛风和家族地中海热 (FMF) 的药物 - - 科尔奇辛的慢性肝脏作用仍未得到充分研究.
- 了解与黄素相关的长期风险对于患者安全和优化治疗策略至关重要.
研究的目的:
- 调查长期使用菌素与新使用者肝硬化发病率之间的关联.
- 为了确定风险因素和量化患肝硬化风险,包括非补偿形式,长期暴露于.
主要方法:
- 一个回顾性队列研究,利用麦卡比医疗保健服务 (MHS) 数据库.
- 包括2000年1月至2018年12月期间开始服用科尔奇辛的18岁以上患者,随访至2020年12月.
- 评估使用覆盖月份 (PMC) 和平均每日剂量 (MDD) 的比例;通过ICD-9代码诊断肝硬化;根据特定临床事件定义的无补偿性肝硬化.
主要成果:
- 总共分析了21,773名患者,确定了129例发生性肝硬化病例.
- 长期使用胆固醇,特别是超过60个月 (HR 6.69,95% CI 3.56-12.56) 和更高的PMC (60-80%组:HR 3.68,95% CI 2.23-6.07) 与肝硬化风险增加有显著关联.
- 家庭地中海热 (FMF),高BMI (>40) 和高FIBROSIS-4 (FIB-4) 分数也与较高的肝硬化发病率有关.
结论:
- 长期使用胆固醇与发生性肝硬化风险增加有关,通常呈现为不补偿性肝病.
- 这些发现支持将长期菌素治疗限制在具有有限治疗替代方案的疾病上,例如FMF.
- 需要进一步研究菌素的肝毒性和风险分层.
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