PMID- 28490012
OWN - NLM
STAT- MEDLINE
DCOM- 20170920
LR  - 20170920
IS  - 1421-9794 (Electronic)
IS  - 0009-3157 (Linking)
VI  - 62
IP  - 5
DP  - 2017
TI  - Is the Prophylactic Use of Hepatoprotectants Necessary in Anti-Tuberculosis 
      Treatment?
PG  - 269-278
LID - 10.1159/000465515 [doi]
AB  - BACKGROUND: Liver injury is one of the serious side effects of anti-tuberculosis 
      (TB) drugs. It is controversial whether hepatoprotectant prophylaxis is efficient 
      and safe in anti-TB treatment, so we aimed to assess the efficacy and safety of 
      hepatoprotectant prophylaxis in patients who had received anti-TB treatment. 
      METHODS: PubMed, the Cochrane library, Embase, Ovid, Springer link, Wiley, 
      Elsevier, Web of Science, and the Karger Online Journal were systematically 
      searched prior to April 2016 for articles related to hepatoprotectant prophylaxis 
      in the treatment of TB. A meta-analysis was conducted to estimate the effect of 
      hepatoprotective agents on liver function and adverse events (AEs) in patients 
      who had received anti-TB drugs. The primary outcomes were changes in alanine 
      transaminase (ALT) and aspartate transaminase (AST) levels. The other outcomes 
      were drug-induced liver injury (DILI) and AEs. RESULTS: In our review, 6 trials 
      that involved 1,227 patients were included. Our analysis indicated that 
      hepatoprotective agents exerted protective effects on liver function in patients 
      who had received anti-TB drugs (weighted mean difference, WMD = -7.81, 95% CI 
      [-12.26, -3.37], p = 0.0006 [ALT]; WMD = -7.07, 95% CI [-11.43, -2.72], p = 0.001 
      [AST]) in any age group. However, in the subgroup analysis of treatment duration, 
      the use of hepatoprotective agents was not associated with significant changes in 
      ALT and AST levels after 2 weeks of treatment and exhibited a positive effect on 
      liver function after 4 weeks of treatment. Moreover, the use of hepatoprotectants 
      significantly decreased the number of DILI cases (risk ratio, RR 0.50, 95% CI 
      [0.34-0.73], p = 0.0004). However, the use of hepatoprotectants led to similar 
      AEs in the control groups (RR 1.07, 95% CI [0.82-1.39], p = 0.62). CONCLUSIONS: 
      The use of hepatoprotective drugs may prevent liver injury in patients who are 
      receiving anti-TB drugs without any significant AEs 4 weeks after the initiation 
      of hepatoprotective medication.
CI  - (c) 2017 S. Karger AG, Basel.
FAU - Xu, Li
AU  - Xu L
AD  - Department of Pharmacy, The First Affiliated Hospital of Xi'an Medical 
      University, Xi'an, PR China.
FAU - Zhang, Fei
AU  - Zhang F
FAU - Xu, Chen
AU  - Xu C
FAU - Liu, Kai-Ge
AU  - Liu KG
FAU - Wu, Wei
AU  - Wu W
FAU - Tian, Ying-Xuan
AU  - Tian YX
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20170511
PL  - Switzerland
TA  - Chemotherapy
JT  - Chemotherapy
JID - 0144731
RN  - 0 (Antitubercular Agents)
RN  - 0 (Protective Agents)
RN  - EC 2.6.1.1 (Aspartate Aminotransferases)
RN  - EC 2.6.1.2 (Alanine Transaminase)
SB  - IM
MH  - Alanine Transaminase/blood
MH  - Antitubercular Agents/*adverse effects/therapeutic use
MH  - Aspartate Aminotransferases/blood
MH  - Chemical and Drug Induced Liver Injury/etiology/*prevention & control
MH  - Databases, Factual
MH  - Humans
MH  - Protective Agents/*therapeutic use
MH  - Risk
MH  - Tuberculosis/drug therapy
OTO - NOTNLM
OT  - Anti-tuberculosis drugs
OT  - Efficacy
OT  - Hepatoprotectant
OT  - Liver injury
OT  - Prophylaxis
OT  - Safety
EDAT- 2017/05/11 06:00
MHDA- 2017/09/21 06:00
CRDT- 2017/05/11 06:00
PHST- 2016/12/15 00:00 [received]
PHST- 2017/02/26 00:00 [accepted]
PHST- 2017/05/11 06:00 [pubmed]
PHST- 2017/09/21 06:00 [medline]
PHST- 2017/05/11 06:00 [entrez]
AID - 000465515 [pii]
AID - 10.1159/000465515 [doi]
PST - ppublish
SO  - Chemotherapy. 2017;62(5):269-278. doi: 10.1159/000465515. Epub 2017 May 11.