Anti-Tuberculosis Drug Induced Liver Injury and Ursodeoxycholic Acid

• 作者: Emad Al-Nemnem Helmut Schiffl Susanne M. Lang
• 来源期刊: 结核病研究(英文)
• 学科: 医学
• 关键词: Ursodeoxycholic Acid HEPATOTOXICITY RIFAMPICIN ISONIAZID PYRAZINAMIDE TUBERCULOSIS
• 年，卷（期）: 2020,（2）
• 页码范围: 66-72
• 页数: 7页
• 分类号: R57

摘要

Hepatotoxicity induced by standard anti-tuberculosis drugs (isoniazid, rifampicin, pyrazinamide) can result in significant morbidity and, rarely, even mortality. This major adverse side-effect of anti-tuberculosis treatment has a negative impact on patient adherence and patient outcomes as well as on tuberculosis control. Early recognition and prompt withdrawal of the offending drugs are the most critical interventions in the management of anti-tuberculosis drug-induced liver injury. No drug or herbal extract has been shown until recently to prevent or reverse anti-tuberculosis drug-induced hepatotoxicity. Ursodeoxycholic acid is the only FDA approved drug for the treatment of primary biliary cholangitis and has also been successfully used in various cholestatic liver diseases. Although still experimental, recent controlled clinical studies suggested that oral administration of ursodeoxycholic acid may prevent the onset of anti-tuberculosis drug-induced liver injury and accelerate the recovery of liver injury. These clinical data are supported by experimental models of anti-tuberculosis drug-induced hepatotoxicity. There is an urgent need for further randomized clinical trials to document the promising hepatoprotective properties of ursodeoxycholic acid.