D-penicillamine原发性胆汁性肝硬化。

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龚Y, Frederiksen SL, Gluud C

D-penicillamine原发性胆汁性肝硬化。

科克伦数据库系统启2004年10月18日;(4):CD004789。

PubMed ID

15495127 (在PubMed

]

文摘

背景:D-penicillamine用于原发性胆汁性肝硬化患者由于其肝铜减少和免疫调节的潜力。随机临床试验的结果不一致。目的:系统综述的有益和有害影响D-penicillamine患者原发性胆汁性肝硬化。必威国际app搜索策略:我们确定了试验通过电子搜索的Cochrane Hepato-Biliary组对照试验注册(2003年9月),对照试验的Cochrane中央注册Cochrane图书馆(问题3,2003),MEDLINE(1966年1月至2003年9月),EMBASE(1980年1月至2003年9月),中国生物医学光盘数据库(1979年1月至2003年8月),和紫丁香(1982 - 2003);通过手动搜索的书目;必威国际app联系作者的试验和制药公司。选择标准:我们包括随机临床试验与安慰剂比较D-penicillamine /不干预或其他控制干预不分语言,年出版,出版地位。数据收集和分析:两个评论者独立评估试验的方法学质量和提取数据,验证了第三个审稿人。主要结果1)死亡率和2)的组合那些死亡或接受了肝移植。我们分析了二分结果相对危险度(RR)和95%可信区间(CI)固定效应模型和随机效应模型。 We investigated sources of heterogeneity by subgroup analyses and tested the robustness of our findings by sensitivity analyses. MAIN RESULTS: We included seven trials randomising 706 patients with primary biliary cirrhosis. D-penicillamine compared with placebo/no intervention tended to increase mortality (RR 1.34, 95% CI 1.09 to 1.64, fixed; RR 1.46, 95% CI 0.85 to 2.50, random). However, there was substantial heterogeneity. No significant differences were detected regarding the risks of mortality or liver transplantation, pruritus, liver complications, progression of liver histological stage, or the levels of liver biochemical variables (except alanine aminotransferase). D-penicillamine versus placebo/no intervention significantly increased the risk of adverse events (RR 3.11, 95% CI 2.33 to 4.16, fixed; RR 4.18, 95% CI 1.38 to 12.69, random). REVIEWERS' CONCLUSIONS: D-penicillamine did not appear to reduce the risk of mortality, but significantly increased the occurrences of adverse events in patients with primary biliary cirrhosis. We do not support the use of D-penicillamine for patients with primary biliary cirrhosis.

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