【据Journal of Hepatology 2020年4月报道】题:原发性胆汁性胆管炎肝移植术后预防性熊去氧胆酸治疗的长期疗效观察(作者Corpechot C等)原发性胆汁性胆管炎(PBC)肝移植术后复发率高,这会损伤移植物和降低患者的生存。熊去氧胆酸(UDCA)...【据Journal of Hepatology 2020年4月报道】题:原发性胆汁性胆管炎肝移植术后预防性熊去氧胆酸治疗的长期疗效观察(作者Corpechot C等)原发性胆汁性胆管炎(PBC)肝移植术后复发率高,这会损伤移植物和降低患者的生存。熊去氧胆酸(UDCA)是目前治疗PBC的标准药物,来自索邦大学圣安东尼研究中心的Corpechot等研究了预防性UDCA治疗对肝移植术后PBC复发的发生率和长期疗效的影响。展开更多
Background Endothelin-receptor blockade provides haemodynamic benefit in expe rimental and clinical heart failure. We aimed to measure the effects of long-te rm endothelin-blockade on left-ventricular (LV) remodelling...Background Endothelin-receptor blockade provides haemodynamic benefit in expe rimental and clinical heart failure. We aimed to measure the effects of long-te rm endothelin-blockade on left-ventricular (LV) remodelling and clinical outco mes in patients with chronic heart failure. Methods 642 patients with chronic he art failure were assigned the oral endothelinA-antagonist darusentan at 10, 25, 50, 100, or 300 mg daily or placebo for 24 weeks in addition to standard therap y in a randomised, doubleblind, placebo-controlled trial. In the 50-300 mg gro ups, darusentan was uptitrated over 6 weeks. Primary endpoint was change in LV e nd-systolic volume (LVESV) at 24 weeks from baseline, measured by MRI. All pati ents for whom assessable MRI scans were available at baseline and follow-up wer e included in the analysis. Findings Darusentan was well tolerated. LVESV could be assessed in 485 (76%) patients with paired MRI data at baseline and 6 months . The change in LVESV was not significantly different from that with placebo at any dose (mean difference from placebo 1.27 mL <<95%CI -9.9 to 12. 4>> with 10 m g dose, -1.84 mL <<-13.0 to 9.3>> with 25 mg, -5.68 mL <<-16.9 to 5.6>> with 50 mg, -4.05 mL <<-15.5 to 7. 4>> with 100 mg, and -4.34 mL <<-15.7 to 7. 0>> with 300 mg). Heart failure worsened in 71 (11.1%) patients, and 30 (4.7%) died dur ing the study with no difference between groups. Interpretation EndothelinA bloc kade with darusentan did not improve cardiac remodelling or clinical symptoms or outcomes in patients with chronic heart failure receiving an angiotensin-conve rting-enzyme inhibitor, βblocker, or aldosterone antagonist. Thus, endothelinA blockade is unlikely to be useful as an add-on treatment in such patients.展开更多
文摘【据Journal of Hepatology 2020年4月报道】题:原发性胆汁性胆管炎肝移植术后预防性熊去氧胆酸治疗的长期疗效观察(作者Corpechot C等)原发性胆汁性胆管炎(PBC)肝移植术后复发率高,这会损伤移植物和降低患者的生存。熊去氧胆酸(UDCA)是目前治疗PBC的标准药物,来自索邦大学圣安东尼研究中心的Corpechot等研究了预防性UDCA治疗对肝移植术后PBC复发的发生率和长期疗效的影响。
文摘Background Endothelin-receptor blockade provides haemodynamic benefit in expe rimental and clinical heart failure. We aimed to measure the effects of long-te rm endothelin-blockade on left-ventricular (LV) remodelling and clinical outco mes in patients with chronic heart failure. Methods 642 patients with chronic he art failure were assigned the oral endothelinA-antagonist darusentan at 10, 25, 50, 100, or 300 mg daily or placebo for 24 weeks in addition to standard therap y in a randomised, doubleblind, placebo-controlled trial. In the 50-300 mg gro ups, darusentan was uptitrated over 6 weeks. Primary endpoint was change in LV e nd-systolic volume (LVESV) at 24 weeks from baseline, measured by MRI. All pati ents for whom assessable MRI scans were available at baseline and follow-up wer e included in the analysis. Findings Darusentan was well tolerated. LVESV could be assessed in 485 (76%) patients with paired MRI data at baseline and 6 months . The change in LVESV was not significantly different from that with placebo at any dose (mean difference from placebo 1.27 mL <<95%CI -9.9 to 12. 4>> with 10 m g dose, -1.84 mL <<-13.0 to 9.3>> with 25 mg, -5.68 mL <<-16.9 to 5.6>> with 50 mg, -4.05 mL <<-15.5 to 7. 4>> with 100 mg, and -4.34 mL <<-15.7 to 7. 0>> with 300 mg). Heart failure worsened in 71 (11.1%) patients, and 30 (4.7%) died dur ing the study with no difference between groups. Interpretation EndothelinA bloc kade with darusentan did not improve cardiac remodelling or clinical symptoms or outcomes in patients with chronic heart failure receiving an angiotensin-conve rting-enzyme inhibitor, βblocker, or aldosterone antagonist. Thus, endothelinA blockade is unlikely to be useful as an add-on treatment in such patients.
