Tsochatzis Emmanuel A, Bosch Jaime, Burroughs Andrew K
The Royal Free Sheila Sherlock Liver Centre, Royal Free Hospital and UCL Institute of Liver and Digestive Health, London, UK.
Expert Rev Gastroenterol Hepatol. 2014 Jul;8(5):571-81. doi: 10.1586/17474124.2014.902303. Epub 2014 Jun 9.
Cirrhosis can be sub-classified in clinical stages with distinct differences in prognosis and can even be reversed in some cases with successful etiological treatment. In this article, we review potential future therapies of cirrhosis, mainly focusing in the expansion of indications of currently licensed drugs. We strongly advocate that future therapies should focus on preventing the advent of complications and further progression of liver disease and should involve both primary and secondary care physicians. Such strategies could be based on the combination of currently licensed, relatively safe and inexpensive drugs and such randomized controlled trials should be prioritized in patients with advanced liver disease. The paradigm should be similar to that of prevention in cardiovascular diseases and long-term follow-up trials are needed.
肝硬化可根据临床阶段进行亚分类，各阶段预后存在明显差异，在某些情况下，通过成功的病因治疗甚至可以逆转。在本文中，我们回顾了肝硬化未来可能的治疗方法，主要关注现有获批药物适应证的拓展。我们强烈主张，未来的治疗应着重预防并发症的出现和肝病的进一步进展，且应涉及初级和二级护理医生。此类策略可基于现有获批的、相对安全且廉价的药物联合使用，对于晚期肝病患者，应优先开展此类随机对照试验。其模式应类似于心血管疾病的预防，需要进行长期随访试验。
