Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya3297110.26442/00403660.2019.02.000130Editorial articleПередовая статьяReview ArticleAdemethionine in the treatment of fatigue in liver diseases: a systematic reviewАдеметионин в лечении повышенной утомляемости/слабости при заболеваниях печени: систематический обзорRaikhelsonK LРайхельсонКарина Леонидовна

д.м.н., проф. научно-клинического и образовательного центра гастроэнтерологии и гепатологии Института высоких медицинских технологий ФГБОУ ВО СПбГУ; тел.: +7(911)911-01-43; ORHID: 0000-0002-8821-6142

kraikhelson@mail.ruKondrashinaE AКондрашинаЭлина Александровна

к.м.н., доц. научно-клинического и образовательного центра гастроэнтерологии и гепатологии Института высоких медицинских технологий ФГБОУ ВО СПбГУ; ORHID: 0000-0002-0142-0264

Saint-Petersburg State UniversityФГБОУ ВО «Санкт-Петербургский государственный университет»15022019912VOL 91, NO2 (2019)ТОМ 91, №2 (2019)13414211042020Copyright ©; 2019, Consilium MedicumCopyright ©; 2019, ООО "Консилиум Медикум"2019Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/32971

Fatigue has a significant effect on the condition of patients with liver disease. Ademethionine is considered one of the most promising drugs for its treatment. Aim. To systematize the published data on the treatment of hepatogenic fatigue with аdemethionine. Materials and methods. Search was performed using databases PubMed, EMBASE, Embase®, Medline®, eLIBRARY.ru, published in 1952-2018. Results and discussion. 16 articles were found on the use of ademethionine in liver diseases and the assessment of the dynamics of the symptom of fatigue, including 1 double-blind, randomized, placebo-controlled study, 3 open randomized studies; most of the works were multicenter open observation programs. The studies included 3238 patients (of which 2820 were included in the final data analysis) and a wide range of liver diseases: alcoholic liver disease, nonalcoholic fatty liver disease, primary biliary cholangitis, primary sclerosing cholangitis, cirrhosis of different causes, viral hepatitis, drug-induced liver injury. Different doses, routes of administration of аdemethionine and the duration of the course were used. Conclusions. Ademethionine, regardless of the route of administration, is effective in the treatment of fatigue due to different liver disease in the short and long term. The dose-dependent effect of the drug and the possibility of maintaining post-effect after end of the treatment course should be assumed, but this requires further study in randomized clinical trials.

Повышенная утомляемость/слабость оказывает существенное влияние на состояние больных при заболеваниях печени. Как один из наиболее перспективных препаратов для ее лечения рассматривается адеметионин. Цель исследования. Систематизация опубликованных данных по лечению гепатогенной слабости адеметионином. Материалы и методы. Проведен поиск по базам PubMed, EMBASE, Embase®, Medline®, eLIBRARY.ru работ, опубликованных в 1952-2018 гг. Результаты и обсуждение. Выявлено 16 работ, посвященных применению адеметионина при заболеваниях печени и оценивающих динамику симптома слабость, среди них одно двойное слепое рандомизированное плацебо-контролируемое исследование, три открытых рандомизированных исследования, большинство работ являлись многоцентровыми открытыми наблюдательными программами. Исследования включали 3238 пациентов (из которых 2820 вошли в окончательный анализ данных) и широкий спектр заболеваний печени: алкогольную болезнь печени, неалкогольную жировую болезнь печени, первичный билиарный холангит, первичный склерозирующий холангит, цирроз печени разного генеза, вирусные гепатиты, лекарственное поражение печени. Использовались различные дозы, пути введения адеметионина и длительность курса. Заключение. Адеметионин, независимо от пути введения, эффективен в лечении слабости при различных заболеваниях печени, как при краткосрочном, так и при длительном применении. Следует предполагать дозозависимый эффект препарата и возможность сохранения последействия по окончании курса лечения, но это требует дальнейшего изучения в рандомизированных клинических исследованиях.

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