A Randomized Controlled Trial of Glycyrrhizin Plus Tenofovir Vs. Tenofovir in Chronic Hepatitis B with Severe Acute Exacerbation

Overview

Journal Clin Transl Gastroenterol

Specialty Gastroenterology

Date 2017 Jun 30

PMID 28662023

Citations 6

Authors

Chao-Hung Hung

Kwong-Ming Kee

Chih-Hung Chen

Po-Lin Tseng

Ming-Chao Tsai

Chien-Hung Chen

Jing-Houng Wang

Kuo-Chin Chang

Yuan-Hung Kuo

Yi-Hao Yen

Tsung-Hui Hu

Sheng-Nan Lu

Affiliations

Soon will be listed here.

Abstract

Objectives: Severe acute exacerbation (SAE) of chronic hepatitis B (CHB) may progress to liver failure with high potential mortality despite the prompt treatment with nucleos(t)ide analogs. This study aimed to evaluate the efficacy and safety of glycyrrhizin in the treatment of CHB with SAE.

Methods: Sixty patients with SAE of CHB were randomly treated with tenofovir plus intravenous glycyrrhizin (group A, n=30) or with tenofovir alone (group B, n=30). Primary end points were the improvement of serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) and model for end-stage liver disease (MELD) score. Secondary end point was overall mortality or receipt of liver transplantation by week 24.

Results: Patients in group A had significant reductions of serum AST and ALT levels from baseline at days 3, 5, 8, and 15 than those in group B (all P<0.05). The MELD score significantly decreased since week 1 in the group A patients, whereas there were no changes relative to baseline in group B patients at weeks 1 and 2. By week 24, one (3.3%) of group A patients and four (13.3%) of group B patients died (n=3) or received liver transplantation (n=1) (P=0.177). Multivariate analysis identified baseline MELD score (P=0.021) as an independent factor for mortality or receipt of liver transplantation. There were no differences in the rates of grade 3 hypertension, hypokalemia and ascites between two groups.

Conclusions: Early introduction of glycyrrhizin can be safe and helpful for patients with SAE of CHB.

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