Timo Itzel, Thomas Falconer, Ana Roig, Jimmy Daza, Jimyung Park, Jae Youn Cheong, Rae Woong Park, Isabella Wiest, Matthias P Ebert, George Hripcsak, Andreas Teufel
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Patient data were obtained through the \"The Observational Health Data Sciences and Informatics consortium,\" an open-source, multi-stakeholder, and interdisciplinary collaborative effort.</p><p><strong>Results: </strong>The use of aspirin (p = 0.000, p = 0.000), metoprolol (p = 0.002, p = 0.000), and metformin (p = 0.000, p = 0.000) confers a survival benefit for both AUSOM- and NY-treated cohorts. Need of catecholamines dobutamine (p = 0.000, p = 0.000) and dopamine (p = 0.000, p = 0.000) was strongly indicative of poor survival. β-Blocker treatment with metoprolol (p = 0.128, p = 0.196) or carvedilol (p = 0.520, p = 0.679) was not shown to be protective in any of the female subgroups.</p><p><strong>Conclusion: </strong>Overall, our data fill a large gap in long-term, real-world data on patients with ALD, confirming an impact of metformin, acetylsalicylic acid, and β-blockers on ALD patient's survival. 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引用次数: 1
摘要
背景:酒精性肝病(ALD)仍在增加,并导致急性肝损伤,但也导致肝硬化和随后的并发症,如肝衰竭或肝细胞癌(HCC)。由于大多数患者无法实现戒酒,因此确定替代治疗方案以改善ALD患者的预后至关重要。方法:评估来自美国和韩国的两大ALD患者队列,共12,006例患者,我们调查了2000年至2020年期间阿司匹林、二甲双胍、美托洛尔、多巴胺和多巴酚丁胺等药物对ALD患者生存的影响。患者数据是通过“观察健康数据科学和信息学联盟”获得的,这是一个开源、多利益相关者和跨学科的合作努力。结果:阿司匹林(p = 0.000, p = 0.000)、美托洛尔(p = 0.002, p = 0.000)和二甲双胍(p = 0.000, p = 0.000)的使用给AUSOM和ny治疗的队列带来了生存获益。儿茶酚胺、多巴酚丁胺(p = 0.000, p = 0.000)和多巴胺(p = 0.000, p = 0.000)的需要强烈表明生存不良。β受体阻滞剂联合美托洛尔(p = 0.128, p = 0.196)或卡维地洛(p = 0.520, p = 0.679)在任何女性亚组中均未显示出保护作用。结论:总体而言,我们的数据填补了ALD患者长期真实数据的巨大空白,证实了二甲双胍、乙酰水杨酸和β受体阻滞剂对ALD患者生存的影响。然而,性别和种族背景导致这些患者的疗效存在差异。
Efficacy of Co-Medications in Patients with Alcoholic Liver Disease.
Background: Alcoholic liver disease (ALD) is still increasing and leads to acute liver injury but also liver cirrhosis and subsequent complications such as liver failure or hepatocellular carcinoma (HCC). As most patients fail to achieve alcohol abstinence, it is essential to identify alternative treatment options in order to improve the outcome of ALD patients.
Methods: Evaluating two large cohorts of patients with ALD from the USA and Korea with a total of 12,006 patients, we investigated the effect on survival of aspirin, metformin, metoprolol, dopamine, and dobutamine drugs in patients with ALD between 2000 and 2020. Patient data were obtained through the "The Observational Health Data Sciences and Informatics consortium," an open-source, multi-stakeholder, and interdisciplinary collaborative effort.
Results: The use of aspirin (p = 0.000, p = 0.000), metoprolol (p = 0.002, p = 0.000), and metformin (p = 0.000, p = 0.000) confers a survival benefit for both AUSOM- and NY-treated cohorts. Need of catecholamines dobutamine (p = 0.000, p = 0.000) and dopamine (p = 0.000, p = 0.000) was strongly indicative of poor survival. β-Blocker treatment with metoprolol (p = 0.128, p = 0.196) or carvedilol (p = 0.520, p = 0.679) was not shown to be protective in any of the female subgroups.
Conclusion: Overall, our data fill a large gap in long-term, real-world data on patients with ALD, confirming an impact of metformin, acetylsalicylic acid, and β-blockers on ALD patient's survival. However, gender and ethnic background lead to diverse efficacy in those patients.
期刊介绍:
Each issue of this journal is dedicated to a special topic of current interest, covering both clinical and basic science topics in gastrointestinal function and disorders. The contents of each issue are comprehensive and reflect the state of the art, featuring editorials, reviews, mini reviews and original papers. These individual contributions encompass a variety of disciplines including all fields of gastroenterology. ''Digestive Diseases'' bridges the communication gap between advances made in the academic setting and their application in patient care. The journal is a valuable service for clinicians, specialists and physicians-in-training.