An open-label, controlled trial of the efficacy and safety of Laennec to improve liver function in patients with non-alcoholic fatty liver disease

V. T. Tran, I. Yu. Torshin, O. A. Gromova
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Abstract

Aim. Evaluation of the efficacy and safety of human placenta hydrolyzate (HPH) Laennec in the treatment of non-alcoholic fatty liver disease (NAFLD) in an experimental and clinical study. Material and methods. An experimental study was carried out on NAFLD models reproducible by administering various doses of CCl4 to rats. The clinical study involved patients with NAFLD (n=60, mean age 47±9 years) who were on a standard diet of the military hospital of the Republic of Vietnam. Half of the patients (n=30) received Laennec (2 ml/day IM, 4 weeks), while the other half were in the control group. The collected results were analyzed by standard methods of mathematical statistics. Results. Studies in a preclinical model of NAFLD in rats showed a significant reduction in the progression of liver fibrosis against the background of improved lipid metabolism. No negative effects of HPH on the nervous, cardiovascular and respiratory systems of animals have been established. In a clinical study, the mean levels of liver dysfunction markers (AST, ALT, GGT) of patients with NAFLD at the time of treatment initiation in both groups were significantly higher than the normal range (AST - 111±12 U/l, ALT - 103±8 U/l, GGT - 462±60 IU/l). The use of Laennec led to a significant decrease in the incidence of NAFLD symptoms (fatigue, a feeling of bloating in the abdominal cavity, anorexia) and a decrease in the levels of AST, ALT, GGT after a day of the therapy week. After 2 weeks of HLP therapy, there was a significant decrease in the levels of AST (53±4 U/l, control: 99±14 U/l, P<0.001), ALT (71±6 U/l, control: 92±7 U/l, P<0.001) and GGT (260±21 IU/l, control: 384±74 U/l, P<0.001). After 4 weeks of treatment, the parameters significantly decreased towards the lower limit of the normal interval: AST - 45±4 U/l, ALT - 52±5 U/l, GGT - 191±19 IU/l (all P<0.05 compared with the values at 2nd week) against the background of the absence of positive dynamics in the levels of AST, ALT, GGT in the control group. The use of the drug did not cause statistically significant changes in the parameters of clinical or laboratory hematological examination, urinalysis results, levels of other liver enzymes, as well as vital signs. Multivariate analysis showed that the effects of HPH are practically independent of age, gender, medical history, initial levels of AST, ALT, GGT, and other parameters of the biochemical blood test of patients. Conclusion. HPH Laennec is an effective and safe monotherapy for NAFLD.
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一项关于Laennec改善非酒精性脂肪性肝病患者肝功能的疗效和安全性的开放标签对照试验
的目标。人胎盘水解物(HPH) Laennec治疗非酒精性脂肪性肝病(NAFLD)的有效性和安全性的实验和临床研究评价材料和方法。采用不同剂量CCl4对大鼠进行可复制的NAFLD模型实验研究。临床研究纳入60例NAFLD患者,平均年龄47±9岁,采用越南共和国军队医院标准饮食。一半的患者(n=30)接受Laennec (2 ml/d IM, 4周),另一半为对照组。收集的结果用数理统计的标准方法进行分析。结果。对大鼠NAFLD临床前模型的研究显示,在改善脂质代谢的背景下,肝纤维化的进展显著减少。HPH对动物的神经系统、心血管系统和呼吸系统没有负面影响。在一项临床研究中,两组NAFLD患者治疗开始时肝功能障碍标志物(AST、ALT、GGT)的平均水平均显著高于正常范围(AST - 111±12 U/l, ALT - 103±8 U/l, GGT - 462±60 IU/l)。使用Laennec可显著降低NAFLD症状的发生率(疲劳、腹腔腹胀感、厌食症),并在治疗周的一天后降低AST、ALT、GGT水平。HLP治疗2周后,AST(53±4 U/l,对照组:99±14 U/l, P<0.001)、ALT(71±6 U/l,对照组:92±7 U/l, P<0.001)、GGT(260±21 IU/l,对照组:384±74 U/l, P<0.001)水平显著降低。治疗4周后,在对照组AST、ALT、GGT均无阳性动态的背景下,各指标均显著降低至正常间期下限:AST - 45±4u /l, ALT - 52±5u /l, GGT - 191±19 IU/l(与第2周比较均P<0.05)。该药物的使用对临床或实验室血液学检查、尿液分析结果、其他肝酶水平以及生命体征的参数没有造成统计学意义上的显著变化。多因素分析表明,HPH的影响几乎与患者的年龄、性别、病史、初始AST、ALT、GGT水平等血液生化检查参数无关。结论。HPH Laennec是一种有效且安全的NAFLD单药疗法。
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