Troglitazone-induced fulminant hepatic failure. Acute Liver Failure Study Group.
Troglitazone-induced fulminant hepatic failure. Acute Liver Failure Study Group.
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曲格列酮诱发的暴发性肝衰竭。
DOI：
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发表时间：
2000
影响因子：
3.1
通讯作者：
Robert J. Fontana
中科院分区：
文献类型：
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作者：
Elizabeth Murphy;Elizabeth Murphy;T. Davern;A. Shakil;A. Shakil;Lawton Shick;Umesh Masharani;Umesh Masharani;Hsichao Chow;Hsichao Chow;Chris E. Freise;Chris E. Freise;William M. Lee;William M. Lee;Nathan M. Bass;Nathan M. Bass;George Ostapowicz;Anne Larson;Cary Caldwell;Marion G. Peters;S. Rouillard;E. Atillasoy;H. Bodenheimer;T. Schiano;T. Mccashland;J. E. Hay;Russell H. Wiesner;J. Crippin;Tom Faust;J. Rakela;A. Blei;S. Flamm;K. Benner;Steven H. Han;Paul Martin;R. Stribling;E. Schiff;Robert J. Fontana
这三个报告的病例表明，曲格列酮是一种特异性肝毒素，可导致不可逆的肝损伤。因此，曲格列酮的处方应谨慎，当有潜在毒性较低的替代品可用时，不应将其作为治疗II型糖尿病的一线药物。与曲格列酮相关的肝毒性是药物级效应还是曲格列酮特有的，还有待观察。目前正在进行临床试验的其他噻唑烷二酮可能能够提供曲格列酮的治疗益处，而不会产生明显的肝毒性。如果使用曲格列酮，必须经常监测血清转氨酶和症状。然而，正如这些病例和迄今为止报道的其他病例所表明的那样，曲格列酮诱导的肝损伤的发病是潜伏的，并且在时间上是可变的。因此，密切监测的价值以及何时（如果有的话）停止这种监测是安全的，目前尚不清楚。
The three reported cases demonstrate that troglitazone is an idiosyncratic hepatotoxin that can lead to irreversible liver injury. Thus, troglitazone should be prescribed with caution and should not be used as a first-line agent in the treatment of type II DM when potentially less toxic alternatives are available. It remains to be seen whether the hepatotoxicity associated with troglitazone is a drug-class effect or specific to troglitazone. Other thiazolidinediones currently in clinical trials may be able to provide the therapeutic benefits of troglitazone without significant hepatotoxicity. If troglitazone is used, frequent monitoring of serum aminotransferases and symptoms is mandatory. However, as illustrated by these and other cases reported to date, the onset of troglitazone-induced liver injury is insidious and temporally variable. Thus, the value of close monitoring and when, if ever, it is safe to stop such monitoring are currently unclear.