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Liver function monitoring: a prospective nested case-control study of Salvia miltiorrhiza polyphenol injection.

ABSTRACT: Instructions for Salvia miltiorrhiza polyphenol injections indicate abnormal liver function as an occasional adverse reaction, but the incidence of this adverse drug reaction (ADR) has increased in recent years. We assessed S. miltiorrhiza polyphenol ADRs by performing a nested case-control study(NCCS) and meta-analysis. In the NCCS, 2633 patients receiving this treatment in the First Affiliated Hospital of Bengbu Medical College were enrolled. Logistic regression models found that in 58 (2.2%) patients experiencing abnormal liver function, the risk for liver dysfunction was associated with sulfa drug allergy (OR?=?7.874, 95%CI (1.280, 48.447), P?=?0.026), payment methods (OR?=?0.106, 95%CI (0.012, 0.934), P?=?0.043), duration of administration (OR?=?0.922, 95%CI (0.862, 0.986), P?=?0.017), cefathiamidine (OR?=?0.441, 95%CI (0.216, 0.900), P?=?0.025), human serum albumin (OR?=?1.958, 95%CI (1.011, 3.789), P?=?0.046), Dazhu Rhodiola injection (OR?=?2.599, 95%CI (1.112, 6.070), P?=?0.027), or reduced glutathione (OR?=?0.394, 95%CI (0.188, 0.826), P?=?0.014). Meta-analysis of reports on S. miltiorrhiza polyphenol ADRs in controlled trials and other observational studies included 676 patients, of which 17 (2.17%; 95%CI (0.0105, 0.0358)) presented with liver dysfunction; associated ADR risk factors included co-administration of other drugs. Our NCCS and meta-analysis had similar ADR incidence rates, which were higher than the rate in the drug instructions. This study provides guidance for assessing liver dysfunction risks associated with S. miltiorrhiza polyphenol injections.

SUBMITTER: Cheng JQ

PROVIDER: S-EPMC7044424 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Liver function monitoring: a prospective nested case-control study of Salvia miltiorrhiza polyphenol injection.

Cheng Jin-Quan JQ Shi Qing-Ping QP Ding Feng F Kong Ling-Ti LT Yu Mei-Ling ML Wang Can C

Scientific reports 20200226 1

Instructions for Salvia miltiorrhiza polyphenol injections indicate abnormal liver function as an occasional adverse reaction, but the incidence of this adverse drug reaction (ADR) has increased in recent years. We assessed S. miltiorrhiza polyphenol ADRs by performing a nested case-control study(NCCS) and meta-analysis. In the NCCS, 2633 patients receiving this treatment in the First Affiliated Hospital of Bengbu Medical College were enrolled. Logistic regression models found that in 58 (2.2%) ...[more]

PMID: 32103121

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Project description:BackgroundPolychlorinated biphenyls (PCBs) were used in electrical equipment and a range of construction materials. Although banned in the United States and most of Europe in the 1970s, they are highly persistent in the environment and bioaccumulate. Whether PCBs are associated with liver cancer risk at general population levels is unknown.MethodsThis study consisted of 136 incident liver cancer cases and 408 matched controls from the Kaiser Permanente Northern California Multiphasic Health Checkup (MHC) cohort and 84 cases and 252 matched controls from the Norwegian Janus cohort. Sera collected in the 1960s-1980s were measured for 37 PCB congeners and markers of hepatitis B (HBV) and C (HCV) infection. Odds ratios (OR) and 95% confidence intervals (CI) for tertiles of each lipid-adjusted PCB were estimated from conditional logistic regression. We also examined the molar sum of congeners in groups: total PCBs; low, medium, and high chlorination; and Wolff functional groups.ResultsConcentrations of individual congeners from the 1960s/1970s sera ranged from 1.3-123.0 and 1.4-116.0 ng/g lipid among MHC cases and controls, respectively, and from 1.9-258.0 and 1.9-271.0 ng/g lipid among Janus cases and controls, respectively. Among MHC participants with sera from the 1960s, collected an average of 27 years before diagnosis among cases, the top tertile of PCBs 151, 170, 172, 177, 178, 180, and 195 was significantly associated with elevated odds of liver cancer (OR range = 2.01-2.38); most of these congeners demonstrated exposure-response trends. For example, ORtertile 3vs1 = 2.38 (95% CI: 1.22-4.64, p-trend = 0.01) for PCB 180. As a group, Wolff group 1b congeners, which are biologically persistent and weak phenobarbital inducers, were associated with increased odds. In MHC participants, ever vs. never HBV or HCV infection modified the PCB-liver cancer associations. There was little evidence of an association between PCBs and odds of liver cancer among the Janus cohort.DiscussionWe observed associations between a number of PCB congeners and increased odds of liver cancer among MHC, but not Janus, participants with sera from the 1960s/1970s.

Dataset Information

Liver function monitoring: a prospective nested case-control study of Salvia miltiorrhiza polyphenol injection.

Publications

Liver function monitoring: a prospective nested case-control study of Salvia miltiorrhiza polyphenol injection.

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