Fan Jian-Gao, Li Ying, Yu Ze, Luo Xing-Xian, Zheng Ping, Hao Xin, Wang Ze-Yuan, Gao Fei, Zhang Guo-Qing, Feng Wan-Yu
Department of Gastroenterology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Pharmacy, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China.
Front Pharmacol. 2022 Mar 7;13:806787. doi: 10.3389/fphar.2022.806787. eCollection 2022.
Liver disease has high prevalence, number, and disease burden in China, and polyene phosphatidyl choline (PPC) is a widely used liver protective drug. We aim to explore the effectiveness and economy of PPC in patients with liver diseases based on real-world research and compare with other hepatoprotective drugs. This is a "three-phase" study from three medical centers, including descriptive study of patients using PPC injection, self-control case study of patients using PPC injection, and specific-disease cohort study of patients using PPC injection or control drugs. The major measurements of liver function for effectiveness analysis were the alanine transaminase (ALT) level changes and recovery rate. The main statistical methods were Wilcoxon signed rank test, test, and Mann-Whitney test. Propensity score matching was applied to reduce bias. Cost-effectiveness analysis, cost minimization analysis, and sensitivity analysis were used for economic evaluation. PPC alone or in combination with glutathione and magnesium isoglycyrrhizinate shows less total hospitalization cost ( < 0.05) and smaller cost-effectiveness ratio and was effective in protecting liver function, especially in patients with liver transplantation or postoperation of nontumor liver disease (ALT decreased significantly after PPC treatment; < 0.05). Glutathione and magnesium isoglycyrrhizinate combined with PPC could enhance the protective function of liver. PPC was an effective and economic liver protective drug in patients with specific liver diseases, and PPC could enhance the liver protective function of glutathione and magnesium isoglycyrrhizinate.
在中国,肝脏疾病的患病率、患病人数及疾病负担均较高,而多烯磷脂酰胆碱(PPC)是一种广泛应用的肝脏保护药物。我们旨在基于真实世界研究探讨PPC对肝脏疾病患者的有效性和经济性,并与其他肝脏保护药物进行比较。这是一项来自三个医学中心的“三阶段”研究,包括对使用PPC注射液患者的描述性研究、使用PPC注射液患者的自身对照病例研究,以及使用PPC注射液或对照药物患者的特定疾病队列研究。用于有效性分析的主要肝功能测量指标为丙氨酸转氨酶(ALT)水平变化和恢复率。主要统计方法为Wilcoxon符号秩检验、检验和Mann-Whitney检验。应用倾向得分匹配以减少偏倚。采用成本效益分析、成本最小化分析和敏感性分析进行经济学评价。单独使用PPC或与谷胱甘肽及异甘草酸镁联合使用时,总住院费用更低(<0.05),成本效益比更小,且在保护肝功能方面有效,尤其是在肝移植患者或非肿瘤性肝病术后患者中(PPC治疗后ALT显著下降;<0.05)。谷胱甘肽及异甘草酸镁与PPC联合使用可增强肝脏保护作用。PPC对特定肝脏疾病患者是一种有效且经济的肝脏保护药物,且PPC可增强谷胱甘肽及异甘草酸镁的肝脏保护功能。