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Prednisolone therapy accelerates recovery of severe drug-induced liver injury: A prospective, randomized controlled study

引用

iliver 2023年第3期2卷 156-162页

作者： Fang-Jiao Song Hong-Ling Liu Ying Sun Tian-Jiao Xu Dong-Ze Li Hai-Bo Wang Shao-Jie Xin Yu-Dong Wang Gregory Cheng George Lau Sa Lv Shao-Li You Bing Zhu Senior Department of Hepatology Fifth Medical Center of Chinese PLA General HospitalBeijing 100005China Humanity and Health Clinical Trial Center Humanity&Health Medical GroupHong Kong SARChina Faculty of Health Science University of MacaoMacao SARChina

Background and aims:drug-induced liver injury(DILI)is one of the most serious adverse drug reactions and its incidence has been increasing *** evidence suggests that immune activation and systemic inflammatory responses are very important in the progression of *** are often used in DILI,but their clinical usefulness remains *** therefore conducted a prospective,randomized controlled study to investigate whether corticosteroid therapy can accelerate recovery and reduce mortality in severe DILI(SDILI).Methods:SDILI patients with total bilirubin?171μmol/L who presented to the Fifth Medical Center of Chinese PLA General Hospital,Beijing from 2016 to 2019 were randomly allocated to prednisolone and control *** endpoints were resolution of SDILI,defined as a decrease in total bilirubin of at least 35μmol/L to<171μmol/L,and overall survival at 6 *** in the prednisolone group received prednisolone 60 mg/day therapy for the first 7 *** with a decrease in total bilirubin of more than 35μmol/L on day 8 continued on tapering doses of prednisolone;otherwise,prednisolone was ***:On day 8,50.75%(34/67)and 26.47%(18/68)of the participants in the prednisolone and control groups,respectively,achieved the primary endpoint(p¼0.002).However,there was no significant difference in overall survival at 6 months:95.52%(64/67)vs.91.18%(62/68)in the prednisolone and control groups,respectively(p¼0.3).All deaths in both groups occurred in patients who failed to achieve SDILI resolution on day ***:Prednisolone therapy may accelerate the recovery of SDILI.

关键词： Randomized study severe drug-induced liver injury Hepatotoxicity Prednisolone Efficacy Accelerated recovery

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