| Autor: |
Eliabe Silva de Abreu, Deivyd Vieira Silva Cavalcante, Jaqueline Cardoso Habib, Jorge Ferreira Jasmineiro Pitanga, Ana Clara Felix de Farias Santos, Guilherme Grossi Lopes Cançado |
| Jazyk: |
angličtina |
| Rok vydání: |
2024 |
| Předmět: |
|
| Zdroj: |
Annals of Hepatology, Vol 29, Iss , Pp 101691- (2024) |
| Druh dokumentu: |
article |
| ISSN: |
1665-2681 |
| DOI: |
10.1016/j.aohep.2024.101691 |
| Popis: |
Conflict of interest: No Introduction and Objectives: High-risk patients with primary biliary cholangitis (PBC) who respond incompletely to ursodeoxycholic acid (UDCA) require additional treatment with fibrates or obeticholic acid (OCA). Despite this, 30-50% of these patients continue to exhibit elevated alkaline phosphatase (ALP) and bilirubin levels, classifying them as difficult-to-treat PBC. This study aims to evaluate the effects of triple therapy (UDCA + OCA + fibrates) on liver biochemistry in patients with difficult-to-treat PBC. Patients / Materials and Methods: We systematically reviewed EMBASE, PubMed, and Cochrane databases to identify eligible studies. Pooled analyses were performed for change-from-baseline data. We also conducted subgroup analyses based on the sequencing of the specific add-on drug used as third-line therapy. Statistical analyses were performed using RStudio (2023.12.1+402). Results and Discussion: Two studies provided change-from-baseline data, encompassing 95 patients under triple therapy, of whom 68.4% (n=65) had fibrates added to UDCA+OCA dual therapy. Overall, patients under triple therapy presented with decreased ALP [-0.82 x upper limit of normal (ULN), 95%CI -0.96 to -0.68], bilirubin (-0.06 x ULN; 95%CI -0.11 to -0.01), and GGT (-3.18 x ULN; 95%CI -4.57 to -1.79) levels compared to the last available result on dual therapy. No significant change was noted for AST (-0.08 x ULN; 95%CI -0.44 to 0.28) and ALT (-0.21 x ULN; 95%CI -0.61 to 0.20) concentrations. However, the addition of OCA to UDCA+fibrates dual therapy significantly reduced AST (-0.53 x ULN; 95%CI -0.73 to -0.33; p-value for subgroup differences < 0.001) and ALT (-0.69 x ULN; -0.97 to -0.40; p |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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