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沙罗格列扎在合并或不合并糖尿病(包括代偿期肝硬化)的非酒精性脂肪性肝病真实世界患者中的疗效和安全性:一家三级医疗中心的经验

Efficacy and safety of saroglitazar in real-world patients of non-alcoholic fatty liver disease with or without diabetes including compensated cirrhosis: A tertiary care center experience.

作者信息

Chaudhuri Sujit, Dutta Agnibha, Chakraborty Sunil Baran Das

机构信息

Department of Gastroenterology AMRI Hospitals Kolkata India.

出版信息

JGH Open. 2023 Feb 20;7(3):215-220. doi: 10.1002/jgh3.12878. eCollection 2023 Mar.

DOI:10.1002/jgh3.12878
PMID:36968568
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10037031/
Abstract

BACKGROUND AND AIM

Saroglitazar, a dual PPAR α/γ agonist, is useful in management of NAFLD and diabetic dyslipidemia. Here, we report the safety and efficacy of saroglitazar in NAFLD patients with or without diabetes including compensated cirrhosis.

METHODS

Patients, started on saroglitazar 4 mg were prospectively evaluated for 52 weeks in a tertiary care center in Eastern India. Effectiveness was measured in terms of anthropometric measurements, fasting blood glucose, LFT, lipid profile, HbA1c, and elastography parameters (LSM and CAP) measured at baseline, 24, and 52 weeks. Adverse drug reactions were monitored.

RESULTS

A total of 112 patients were enrolled in the study, of whom 63 patients were taken up for per-protocol analysis. Mean age was 49.11 ± 11.09 years and 46(73%) were male. Thirty-four (54%) were nondiabetic. Eleven patients had compensated cirrhosis. There was significant improvement of LSM from baseline (11.03 ± 7.19 kPa) to 24-week (9.29 ± 6.39 kPa) and 52-week (8.59 ± 6.35 kPa) values respectively ( < 0.001). Significant reduction was also seen in CAP values, ALT, AST, HbA1c, LDL, total cholesterol, and triglyceride values. There was no significant weight change along the study interval. Pruritus occurred in one patient who required treatment discontinuation and another patient had mild symptomatic loose motion.

CONCLUSIONS

Saroglitazar is effective and safe in improving biochemical parameters and LSM and CAP values irrespective of weight reduction. It may be used in compensated cirrhotics with close monitoring for side effects.

摘要

背景与目的

司美格鲁肽是一种PPARα/γ双重激动剂,可用于治疗非酒精性脂肪性肝病(NAFLD)和糖尿病血脂异常。在此,我们报告司美格鲁肽在伴有或不伴有糖尿病(包括代偿期肝硬化)的NAFLD患者中的安全性和有效性。

方法

在印度东部的一家三级医疗中心,对开始服用4毫克司美格鲁肽的患者进行了为期52周的前瞻性评估。通过在基线、24周和52周时测量人体测量学指标、空腹血糖、肝功能检查、血脂谱、糖化血红蛋白(HbA1c)以及弹性成像参数(肝脏硬度值(LSM)和受控衰减参数(CAP))来评估疗效。监测药物不良反应。

结果

共有112名患者纳入研究,其中63名患者进行符合方案分析。平均年龄为49.11±11.09岁,46名(73%)为男性。34名(54%)患者无糖尿病。11名患者有代偿期肝硬化。LSM从基线值(11.03±7.19千帕)分别显著改善至24周时(9.29±6.39千帕)和52周时(8.59±6.35千帕)的值(P<0.001)。CAP值、谷丙转氨酶(ALT)、谷草转氨酶(AST)、HbA1c、低密度脂蛋白(LDL)、总胆固醇和甘油三酯值也显著降低。在整个研究期间体重无显著变化。1名患者出现瘙痒,需要停药,另1名患者有轻度症状性腹泻。

结论

无论体重是否减轻,司美格鲁肽在改善生化指标、LSM和CAP值方面都是有效且安全的。它可用于代偿期肝硬化患者,但需密切监测副作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8062/10037031/cbc9ac33b02c/JGH3-7-215-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8062/10037031/cbc9ac33b02c/JGH3-7-215-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8062/10037031/cbc9ac33b02c/JGH3-7-215-g001.jpg

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