Поражение органов желудочно-кишечного тракта является частым патологическим процессом, возникающим у пациентов на фоне лечения нестероидными противовоспалительными препаратами (НПВП), что снижает качество жизни больных, обусловливает значительные финансовые потери, возникающие в связи с дорогостоящим лечением. В представленной работе рассмотрены современные взгляды на механизмы поражения печени на фоне приема НПВП и перспективные маркеры диагностики лекарственного поражения печени.
The defeat of the gastrointestinal tract is a frequent pathological process that occurs in patients with joint pathology during treatment with non-steroidal anti-inflammatory drugs (NSAID), which reduces the quality of life of patients, causes significant financial losses arising in connection with expensive treatment. In the present article the modern views on the mechanisms of liver damage against the background of NSAID are considered, promising markers of diagnosis of drug liver damage are considered.
Key words: non-steroidal anti-inflammatory drugs, the risk of drug-induced hepatitis.
1. Anelli MG, Scioscia C, Grattagliano I et al. Old and new antirheumatic drugs and the risk of hepatotoxicity. Ther Drug Monit 2012; 34 (6): 622–8.
2. Aithal G. Nonsteroidal anti-inflammatory drug-induced hepatotoxicity. Clin Liver Dis 2007; 11: 563–75.
3. Bello AE, Kent JD, Grahn AY et al. One-year open-label safety evaluation of the fixed combination of ibuprofen and famotidine with a prospective analysis of dyspepsia. Curr Med Res Opin 2015; 31 (3): 397–405.
4. Rahme E, Joseph L, Kong SX et al. Gastrointestinal health care resource use and costs associated with nonsteroidal antiinfl ammatory drugs versus acetaminophen: retrospective cohort study of an elderly population. Arthritis Rheum 2000; 43: 917–24.
5. DeAbajo FJ, Montero D, Madurga M et al. Acute and clinically relevant drug-induced liver injury: a population based case-control study. Br J Clin Pharmacol 2004; 58: 71–80.
6. Schmeltzer PA, Kosinski AS, Kleiner DE. Liver injury from nonsteroidal anti-inflammatory drugs in the United States. Liver Int 2016; 36 (4): 603–9.
7. Aithal GP, Ramsay L, Daly AK et al. Hepatic adducts, circulating an-tibodies, and cytokine polymorphisms in patients with diclofenac hepatotoxicity. Hepatology 2004; 39: 1430–40.
8. Unzueta A, Vargas HE. Nonsteroidal anti-inflammatory drug-induced hepatoxicity. Clin Liver Dis 2013; 17: 643–56.
9. Teschke R, Frenzel C, Wolff A et al. Drug induced liver injury: Accuracy of diagnosis in published reports. Ann Hepatol 2014; 13: 248–55.
10. Faghihzadeh F, Hekmatdoost A, Adibi P. Resveratrol and liver: A systematic review. J Res Med Sci 2015; 20 (8): 797–810.
11. Reitblat T, Zamir D, Estis L et al. The different patterns of blood pressure elevation by rofecoxib and nabumetone. J Hum Hypertens 2002; 16 (6): 431–4.
12. Bessone F. Non-steroidal anti-inflammatory drugs: What is the actual risk of liver damage? World J Gastroenterol 2010; 16 (45): 5651–61.
13. Laine L, Goldkind L, Curtis SP et al. How common is diclofenac-associated liver injury? Analysis of 17,289 arthritis patients in a long-term prospective clinical trial. AJG 2009; 104: 356–62.
14. Fredriksson L, Wink S, Herpers B et al. Drug-induced endoplasmic reticulum and oxidative stress responses independently sensitize toward TNFa-mediated hepatotoxicity. Toxicol Sci 2014; 140 (1): 144–59.
15. Jessurun N, van Puijenbroek E. Relationship between structural alerts in NSAIDs and idiosyncratic hepatotoxicity: an analysis of spontaneous report data from the WHO database. Drug Saf 2015; 38 (5): 511–5.
16. Наумова О.В., Ахмедов В.А. Участие матриксных металлопротеиназ в механизмах формирования НПВП-гепатопатии у больных остеоартрозом. Вестн. Уральской медицинской академической науки. 2012; 2 (39): 89–90.
[Naumova O.V., Akhmedov V.A. Uchastie matriksnykh metalloproteinaz v mekhanizmakh formirovaniia NPVP-gepatopatii u bol'nykh osteoartrozom. Vestn. Ural'skoi meditsinskoi akademicheskoi nauki. 2012; 2 (39): 89–90 (in Russian).]
17. Ахмедов В.А., Наумова О.В. Прогностические факторы формирования и оптимизация ведения больных сочетанным НПВП-ассоциированным поражением желудка и печени у больных остеоартрозом: методические рекомендации. Омск: ОмГМУ, 2018.
[Akhmedov V.A., Naumova O.V. Prognosticheskie faktory formirovaniia i optimizatsiia vedeniia bol'nykh sochetannym NPVP-assotsiirovannym porazheniem zheludka i pecheni u bol'nykh osteoartrozom: metodicheskie rekomendatsii. Omsk: OmGMU, 2018 (in Russian).]
18. Kullak-Ublick GA, Andrade RJ, Merz M et al. Drug-induced liver injury: recent advances in diagnosis and risk assessment. Gut 2017; 66: 1154–64.
19. Clarke JI, Dear JW, Antoine DJ. Recent advances in biomarkers and therapeutic interventions for hepatic drug safety – false dawn or new horizon? Expert Opin Drug Saf 2016; 15: 625–34.
________________________________________________
1. Anelli MG, Scioscia C, Grattagliano I et al. Old and new antirheumatic drugs and the risk of hepatotoxicity. Ther Drug Monit 2012; 34 (6): 622–8.
2. Aithal G. Nonsteroidal anti-inflammatory drug-induced hepatotoxicity. Clin Liver Dis 2007; 11: 563–75.
3. Bello AE, Kent JD, Grahn AY et al. One-year open-label safety evaluation of the fixed combination of ibuprofen and famotidine with a prospective analysis of dyspepsia. Curr Med Res Opin 2015; 31 (3): 397–405.
4. Rahme E, Joseph L, Kong SX et al. Gastrointestinal health care resource use and costs associated with nonsteroidal antiinfl ammatory drugs versus acetaminophen: retrospective cohort study of an elderly population. Arthritis Rheum 2000; 43: 917–24.
5. DeAbajo FJ, Montero D, Madurga M et al. Acute and clinically relevant drug-induced liver injury: a population based case-control study. Br J Clin Pharmacol 2004; 58: 71–80.
6. Schmeltzer PA, Kosinski AS, Kleiner DE. Liver injury from nonsteroidal anti-inflammatory drugs in the United States. Liver Int 2016; 36 (4): 603–9.
7. Aithal GP, Ramsay L, Daly AK et al. Hepatic adducts, circulating an-tibodies, and cytokine polymorphisms in patients with diclofenac hepatotoxicity. Hepatology 2004; 39: 1430–40.
8. Unzueta A, Vargas HE. Nonsteroidal anti-inflammatory drug-induced hepatoxicity. Clin Liver Dis 2013; 17: 643–56.
9. Teschke R, Frenzel C, Wolff A et al. Drug induced liver injury: Accuracy of diagnosis in published reports. Ann Hepatol 2014; 13: 248–55.
10. Faghihzadeh F, Hekmatdoost A, Adibi P. Resveratrol and liver: A systematic review. J Res Med Sci 2015; 20 (8): 797–810.
11. Reitblat T, Zamir D, Estis L et al. The different patterns of blood pressure elevation by rofecoxib and nabumetone. J Hum Hypertens 2002; 16 (6): 431–4.
12. Bessone F. Non-steroidal anti-inflammatory drugs: What is the actual risk of liver damage? World J Gastroenterol 2010; 16 (45): 5651–61.
13. Laine L, Goldkind L, Curtis SP et al. How common is diclofenac-associated liver injury? Analysis of 17,289 arthritis patients in a long-term prospective clinical trial. AJG 2009; 104: 356–62.
14. Fredriksson L, Wink S, Herpers B et al. Drug-induced endoplasmic reticulum and oxidative stress responses independently sensitize toward TNFa-mediated hepatotoxicity. Toxicol Sci 2014; 140 (1): 144–59.
15. Jessurun N, van Puijenbroek E. Relationship between structural alerts in NSAIDs and idiosyncratic hepatotoxicity: an analysis of spontaneous report data from the WHO database. Drug Saf 2015; 38 (5): 511–5.
16. Naumova O.V., Akhmedov V.A. Uchastie matriksnykh metalloproteinaz v mekhanizmakh formirovaniia NPVP-gepatopatii u bol'nykh osteoartrozom. Vestn. Ural'skoi meditsinskoi akademicheskoi nauki. 2012; 2 (39): 89–90 (in Russian).
17. Akhmedov V.A., Naumova O.V. Prognosticheskie faktory formirovaniia i optimizatsiia vedeniia bol'nykh sochetannym NPVP-assotsiirovannym porazheniem zheludka i pecheni u bol'nykh osteoartrozom: metodicheskie rekomendatsii. Omsk: OmGMU, 2018 (in Russian).
18. Kullak-Ublick GA, Andrade RJ, Merz M et al. Drug-induced liver injury: recent advances in diagnosis and risk assessment. Gut 2017; 66: 1154–64.
19. Clarke JI, Dear JW, Antoine DJ. Recent advances in biomarkers and therapeutic interventions for hepatic drug safety – false dawn or new horizon? Expert Opin Drug Saf 2016; 15: 625–34.
Авторы
В.А. Ахмедов*
ФГБОУ ВО «Омский государственный медицинский университет» Минздрава России, Омск, Россия