The effect of statins on the risk of antituberculosis drug-induced liver injury among patients with active tuberculosis: A cohort study

被引：3
作者：
Huang, Chun-Kai [1 ,2 ,7 ]
Huang, Jei-Yie [2 ,3 ,4 ]
Chang, Chin-Hao [5 ]
Tsai, Shang-Jie [5 ]
Shu, Chin-Chung [1 ]
Wang, Hao-Chien [1 ,6 ]
Chien, Kuo-Liong [1 ,2 ]
机构：
[1] Natl Taiwan Univ Hosp, Dept Internal Med, 7 Chung Shan S Rd, Taipei City 10002, Taiwan
[2] Natl Taiwan Univ, Inst Epidemiol & Prevent Med, Coll Publ Hlth, Taipei, Taiwan
[3] Natl Taiwan Univ Hosp, Dept Nucl Med, Taipei, Taiwan
[4] Natl Taiwan Univ, Coll Med, Taipei, Taiwan
[5] Natl Taiwan Univ Hosp, Dept Med Res, Taipei, Taiwan
[6] Natl Taiwan Univ, Canc Ctr, Taipei, Taiwan
[7] 7 Chung Shan S Rd, Taipei City 10002, Taiwan
来源：
JOURNAL OF MICROBIOLOGY IMMUNOLOGY AND INFECTION | 2024年 / 57卷 / 03期
关键词：
Anti-tuberculosis drug; Drug-induced liver injury; Statin; Tuberculosis; INDUCED HEPATOTOXICITY; THERAPY; HEPATITIS; TB;
D O I：
10.1016/j.jmii.2024.04.002
中图分类号：
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号：
100102 ;
摘要：
Background: Tuberculosis (TB) remains prevalent worldwide, and anti-TB drugs are associated with drug-induced liver injury (DILI). Statins have pleiotropic effects which may decrease inflammation and achieve immunomodulation. However, few studies have investigated the pleiotropic effects of statins on the risk of DILI. The purpose of this study was to investigate whether statins prevent anti-tuberculosis DILI among active TB patients on standard anti-TB drug therapy. Methods: We conducted a hospital-based retrospective cohort study using claims data from the Integrated Medical Database of National Taiwan University Hospital (NTUH-iMD). Patients with a positive TB culture were included. The use of statins was defined as a daily equivalent dose >0.5 mg of pitavastatin. Deterioration in liver function was evaluated according to elevated liver enzyme levels. The primary and secondary endpoints were the DILI and the severe DILI. The prognostic value of statins was evaluated by Kaplan-Meier analysis, and Cox proportional hazards models. Results: A total of 1312 patients with a diagnosis of TB and receiving anti -TB treatment were included. During the study period, 193 patients had the DILI and 140 patients had the severe DILI. Kaplan -Meier analysis showed a significant difference between the usual statin users and controls in the DILI. In multivariable Cox proportional hazards analysis, statins showed a protective effect against the primary and secondary endpoints. In addition, the protective effect of statins showed a dose -response relationship against the DILI. Conclusion: Statin treatment had a protective effect against the risk of anti -TB DILI with a positive dose -response relationship. Copyright (c) 2024, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY -NC -ND license (http://creativecommons.org/licenses/bync-nd/4.0/).
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页码：498 / 508
页数：11
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