Department of Thyroid and Breast Surgery, The First People's Hospital of Honghe State, Mengzi, China.
Department of Blood Transfusion, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
Medicine (Baltimore). 2023 Dec 15;102(50):e36538. doi: 10.1097/MD.0000000000036538.
Currently, drug-induced liver injury (DILI) has become one of those public issues in society, which has added a huge burden to both the individuals and the society. In the current clinical stage, there are numerous drugs developed to treat this disease, and different drug treatment measures have been proven to achieve certain clinical efficacy in the corresponding randomized controlled trials. However, there are still many therapeutic drugs that have not been directly compared and studied. Therefore, it is difficult to directly compare the effectiveness and safety of various strategies for the treatment of DILI. In this regard, the present study collected the therapeutic efficacy of diverse treatments in DILI in recent years through network meta-analysis, evaluated and screened the existing optimal clinical therapeutic plan, and helped physicians formulate clinical therapeutic plans.
Databases, including the Chinese Journal Full-text Database, Wanfang Data Journal Paper Resources (Wangfang), VIP Chinese Science and Technology Journal Full-text Database, The Cochrane Library, PubMed, and EMBASE, were searched using keywords from inception to January 2023. Eligible randomized controlled trials were selected in line with eligibility criteria, and mesh meta-analysis of binary variables was carried out using Stata 16 software.
In combination with alanine aminotransferase, aspartate aminotransferase, and total bilirubin, MI may be the intervention measure for minimizing alanine aminotransferase levels in patients after treatment. Besides, compound glycyrrhizin may be the intervention for minimizing aspartate aminotransferase levels in patients after treatment, and polyene phosphatidylcholine may be the intervention for minimizing total bilirubin levels in patients after treatment. Placebo is the potential intervention that has the least adverse reactions post-treatment, and RT has the second least adverse reactions. Moreover, hepatocyte growth-promoting factors may be the most effective intervention after treatment.
To sum up, the present work compared the clinical effects of 13 liver protective drugs through meta-analysis and provided a systematic understanding of commonly used drugs for the treatment of DILI in clinical practice.
目前，药物性肝损伤（DILI）已成为社会公共问题之一，给个体和社会均带来了巨大负担。在当前临床阶段，有许多药物被开发用于治疗这种疾病，并且不同的药物治疗措施在相应的随机对照试验中已被证明具有一定的临床疗效。然而，仍有许多治疗药物尚未进行直接比较和研究。因此，很难直接比较治疗 DILI 的各种策略的有效性和安全性。在这方面，本研究通过网络荟萃分析收集了近年来 DILI 多种治疗方法的疗效，评估和筛选了现有的最佳临床治疗方案，帮助医生制定临床治疗方案。
使用从开始到 2023 年 1 月的关键词，通过中国期刊全文数据库、万方数据知识服务平台、维普中文科技期刊数据库、The Cochrane Library、PubMed 和 EMBASE 等数据库进行检索。符合纳入标准的随机对照试验被筛选出来，并使用 Stata 16 软件进行二项变量的网状荟萃分析。
结合丙氨酸氨基转移酶、天冬氨酸氨基转移酶和总胆红素，MI 可能是治疗后患者丙氨酸氨基转移酶水平最低的干预措施。此外，复方甘草酸苷可能是治疗后患者天冬氨酸氨基转移酶水平最低的干预措施，多烯磷脂酰胆碱可能是治疗后患者总胆红素水平最低的干预措施。安慰剂是治疗后不良反应最少的潜在干预措施，RT 是不良反应第二少的干预措施。此外，肝细胞生长因子可能是治疗后最有效的干预措施。
综上所述，本研究通过荟萃分析比较了 13 种肝保护药物的临床效果，为了解临床上常用的 DILI 治疗药物提供了系统的认识。
