Yan Brian, Leung Yvette, Urbanski Stefan J, Myers Robert P
Department of Medicine, University of Calgary, Alberta.
Can J Gastroenterol. 2006 May;20(5):351-5. doi: 10.1155/2006/356434.
Rofecoxib is a member of the coxib family of nonsteroidal anti-inflammatory drugs that selectively inhibit cyclooxygenase-2. Although the coxibs are generally well-tolerated, rofecoxib was recently withdrawn from the market due to concerns regarding cardiovascular safety. Rare cases of hepatic injury attributable to the coxibs have been reported. In the present study, two additional cases of severe hepatotoxicity are described in patients with cholestatic symptoms and abnormal liver biochemistry, shortly following the initiation of rofecoxib for arthritic complaints. In both cases, liver histology was compatible with drug-induced hepatotoxicity, and rapid clinical and biochemical improvements were observed following rofecoxib discontinuation. With new coxibs and expanding indications on the horizon, physicians in all areas of practice must be aware of this disorder and consider it in any patient who develops hepatic dysfunction after taking a coxib.
罗非昔布是一类选择性抑制环氧化酶-2的非甾体抗炎药——昔布类药物的成员。尽管昔布类药物总体耐受性良好，但由于对心血管安全性的担忧，罗非昔布最近已退出市场。已有报道称昔布类药物可导致罕见的肝损伤病例。在本研究中，描述了另外两例严重肝毒性病例，患者在因关节炎症状开始服用罗非昔布后不久，出现胆汁淤积症状和肝脏生化指标异常。在这两例病例中，肝脏组织学表现符合药物性肝毒性，停用罗非昔布后临床和生化指标迅速改善。随着新型昔布类药物的出现以及适应证的不断扩大，所有执业领域的医生都必须了解这种疾病，并在任何服用昔布类药物后出现肝功能障碍的患者中考虑这一情况。
