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学科主题: 临床医学
题名:
Case-Control Study on Prednisolone Combined With Ursodeoxycholic Acid and Azathioprine in Pure Primary Biliary Cirrhosis With High Levels of Immunoglobulin G and Transaminases Efficacy and Safety Analysis
作者: Fang, Yu-Qing1,2; Lv, Dong-Xia3; Jia, Wei1,2; Li, Jun1,2; Deng, Yong-Qiong1,2; Wang, Yan1,2; Yu, Min1,2; Wang, Gui-Qiang1,2
刊名: MEDICINE
发表日期: 2014-10-01
DOI: 10.1097/MD.0000000000000104
卷: 93, 期:20
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: RANDOMIZED CONTROLLED-TRIALS ; BIOCHEMICAL RESPONSE ; DOUBLE-BLIND ; THERAPY ; BUDESONIDE ; FIBROSIS ; PLACEBO ; PREDICT ; INDEX
英文摘要:

To the best of our knowledge, this is the first study to address the use of glucocorticoids in the comparatively special population of pure primary biliary cirrhosis (PBC) patients who have high levels of immunoglobulin G (IgG) and transaminases but do not have PBC-autoimmune hepatitis overlap syndrome. Ursodeoxycholic acid (UDCA) is now assumed to be the standard therapy for PBC patients. However, patients treated with UDCA still have a risk of progression to cirrhosis and end-stage liver disease. The most recent European Association for the Study of the Liver guidelines of 2009 declared that further studies on glucocorticoid therapy in this disease should be a priority. Therefore, we designed this 3-year longitudinal retrospective study, which might provide deep insight into the treatment for PBC.

The aim of this study was to assess whether the combination of prednisolone, UDCA, and azathioprine was superior to UDCA alone in these PBC patients.

Sixty patients were enrolled in this study. Thirty-one patients underwent UDCA monotherapy, and 29 patients were treated with prednisolone, UDCA, and azathioprine. We analyzed their biochemistries, immune parameters, liver synthetic function, and noninvasive assessments of liver fibrosis, as well as treatment efficacy and adverse effects at baseline and at 1, 3, 6, 12, 24, and 36 months.

Alkaline phosphatase (ALP), gamma-glutamyl transpeptidase, alanine aminotransferase, and aspartate aminotransferase levels and the aspartate aminotransferase-to-platelet ratio index (APRI) and S-index improved dramatically in both groups, whereas IgG levels only decreased in the combination group (all P<0.05). Albumin (ALB) levels decreased in the UDCA group but increased with the combination treatment at 36 months. Significant differences between the 2 groups were observed at 36 months in ALP (P = 0.005), IgG (P = 0.002), ALB (P = 0.002), APRI (P = 0.015), and S-index (P = 0.020). Prednisolone combined with UDCA and azathioprine showed a higher efficacy based on our new criteria.

The combination of prednisolone, UDCA, and azathioprine is superior to UDCA alone for the treatment of pure PBC patients with high levels of IgG and transaminases. Side effects were minimal or absent.

语种: 英语
项目资助者: key disciplines of Beijing ; key clinical medical disciplines of China
WOS记录号: WOS:000344146400005
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/64851
Appears in Collections:北京大学第一临床医学院_感染疾病科_期刊论文

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作者单位: 1.Peking Univ, Hosp 1, Ctr Liver Dis, Beijing 100871, Peoples R China
2.Peking Univ, Hosp 1, Dept Infect Dis, Beijing 100871, Peoples R China
3.Sixth Hosp Shenyang, Dept Infect Dis, Shenyang, Liaoning, Peoples R China

Recommended Citation:
Fang, Yu-Qing,Lv, Dong-Xia,Jia, Wei,et al. Case-Control Study on Prednisolone Combined With Ursodeoxycholic Acid and Azathioprine in Pure Primary Biliary Cirrhosis With High Levels of Immunoglobulin G and Transaminases Efficacy and Safety Analysis[J]. MEDICINE,2014,93(20).
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