Antipruritic effect of bezafibrate and serum autotaxin measures in patients with primary biliary cholangitis
Antipruritic effect of bezafibrate and serum autotaxin measures in patients with primary biliary cholangitis
复制标题
DOI：
10.1136/gutjnl-2018-317426
复制
发表时间：
2018-09
期刊：
影响因子：
24.5
通讯作者：
A. Kremer;Aline Le Cleac'h;S. Lemoinne;K. Wolf;L. de Chaisemartin;S. Chollet-Martin;L. Humbert;D. Rainteau;R. Poupon;A. Rousseau;O. Chazouilleres;C. Corpechot
中科院分区：
文献类型：
--
作者：
A. Kremer;Aline Le Cleac'h;S. Lemoinne;K. Wolf;L. de Chaisemartin;S. Chollet-Martin;L. Humbert;D. Rainteau;R. Poupon;A. Rousseau;O. Chazouilleres;C. Corpechot
我们怀着极大的兴趣阅读了英国胃肠病学会最近关于原发性胆汁性胆管炎（PBC）治疗和管理的指南。1作者提出了一种实用的药物方法来治疗胆汁淤积性瘙痒症，其中消胆胺作为一线药物，利福平作为二线药物，其次是纳曲酮、舍曲林或加巴喷丁作为三线药物，尽管考虑到耐受性和不良事件。瘙痒是PBC的一种特征性的、潜在的痛苦症状，仍然没有得到很好的治疗。2明确需要新的药物选择来缓解患者的这种症状。苯扎贝特是一种过氧化物酶体增殖物激活受体的泛激动剂，已被认为可以减轻PBC患者的瘙痒强度。3最近，在安慰剂对照的III期试验中证实了这种有益作用-苯扎贝特联合熊去氧胆酸治疗PBC（BEZURSO）。4苯扎贝特改善PBC患者瘙痒的机制尚不清楚。由于溶血磷脂酶自分泌运动因子（ATX）及其产物溶血磷脂酸已被确定为胆汁淤积性瘙痒症发病机制中的潜在关键参与者，5因此BEZURSO试验的当前事后分析旨在研究ATX在PBC患者中苯扎贝特抗炎症作用中的作用。所有患者在入选时均符合以下标准：（1）PBC诊断和（2）...
It was with great interest that we read the recent guidelines from the British Society of Gastroenterology on the treatment and management of primary biliary cholangitis (PBC).1 The authors propose a pragmatic drug approach to treat cholestatic pruritus with cholestyramine as first-line and rifampicin as second-line use, followed by naltrexone, sertraline or gabapentin as third-line options, although with concerns regarding tolerability and adverse events. Pruritus is a characteristic, potentially agonising symptom of PBC that remains poorly cared.2 New drug options are definitively needed to relieve patients of this symptom. Bezafibrate, a pan-agonist of peroxisome proliferator-activated receptors, has been suggested to reduce itch intensity in patients with PBC.3 This beneficial effect has recently been confirmed in a placebo-controlled phase III trial Bezafibrate in Combination with Ursodeoxycholic Acid in PBC (BEZURSO).4 The mechanisms by which bezafibrate improves pruritus in PBC remain unknown. As the lysophospholipase autotaxin (ATX) and its product, lysophosphatidic acid, have been identified as potential key players in the pathogenesis of cholestatic pruritus,5 the present post-hoc analysis of the BEZURSO trial aims to investigate the role of ATX in the antipruritic effect of bezafibrate in patients with PBC. All patients met the following criteria at inclusion: (1) PBC diagnosis and (2) …