Department of Pharmacy, The Affiliated Anyang Tumor Hospital of Henan University of Science and Technology, Huanbin North Road, Anyang City, 455000, Henan Province, China.
Sci Rep. 2024 Feb 14;14(1):3674. doi: 10.1038/s41598-024-54314-3.
As part of supportive therapy, prophylaxis with tiopronin for injection (TI) against common hepatotoxicity complications has often been used. However, methods to prevent hepatotoxicity have not been established. Therefore, our study was aimed to find out the relationship between the periods of TI prophylaxis and post-treatment hepatotoxicity, and evaluated the value of prolonging the duration of TI administration in preventing hepatotoxicity. Hepatotoxicity was detected through liver transaminases, bilirubin, alkaline phosphatase, and clinical features of liver insufficiency. Multivariable logistic regressions were conducted to examine the association of the periods of TI prophylaxis and post-treatment hepatotoxicity. Between January 2022 and March 2023, a total of 452 patients with gynecological cancer were enrolled in the study, of which 93 (20.58%) participants were post-treatment hepatotoxicity positive. TI with different prevention days were no significant difference among participants with or without post-treatment hepatotoxicity in crude model (P > 0.05). The P-value, the odds ratios (OR) and 95% confidence intervals (CI) of participants with TI prophylaxis for 1 day for post-treatment hepatotoxicity were 0.040, 3.534 (1.061-11.765) in fully adjusted model. Past history of hepatotoxicity is a confounding variable, and there was no significant difference for post-treatment hepatotoxicity when stratified by past history of hepatotoxicity (P > 0.05). The study indicate that the periods of TI prophylaxis is not associated with post-treatment hepatotoxicity, suggesting that prolonged the periods of TI prophylaxis might be an invalid method for the prevention of post-treatment hepatotoxicity.
在支持性治疗中,经常使用注射用硫普罗宁(TI)预防常见的肝毒性并发症。然而,预防肝毒性的方法尚未建立。因此,我们的研究旨在探讨 TI 预防时间与治疗后肝毒性之间的关系,并评估延长 TI 给药时间预防肝毒性的价值。通过肝转氨酶、胆红素、碱性磷酸酶和肝功能不全的临床特征检测肝毒性。采用多变量逻辑回归分析 TI 预防时间与治疗后肝毒性之间的关联。2022 年 1 月至 2023 年 3 月,共纳入 452 例妇科癌症患者,其中 93 例(20.58%)患者治疗后出现肝毒性。在粗模型中,治疗后肝毒性阳性与阴性患者的 TI 不同预防天数之间无显著差异(P>0.05)。完全调整模型中,TI 预防 1 天的患者发生治疗后肝毒性的 P 值、比值比(OR)和 95%置信区间(CI)分别为 0.040、3.534(1.061-11.765)。既往有肝毒性史是混杂因素,按既往有肝毒性史分层后,治疗后肝毒性无显著差异(P>0.05)。研究表明,TI 预防时间与治疗后肝毒性无关,提示延长 TI 预防时间可能不是预防治疗后肝毒性的有效方法。