STATINS AND URSODEOXYCHOLIC ACID: COOPERATION OR NEUTRALITY?
https://doi.org/10.20996/1819-6446-2009-5-6-51-54
Abstract
Results of combined therapy of gallstone disease (GSD), non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH) and hypercholesterolemia (HCE) with statins and ursodeoxycholic acid (UDCA) are analyzed. In GSD statin therapy was often accompanied with reduction of bile lithogenicity but did not always accelerate stone litholysis under their combination with UDCA. Statin induced liver injuries are often observed in NAFLD and NASH, adjuvant UDCA therapy shown positive effect on inflammatory and histological liver parameters in these diseases. Serum lipid levels in patients with HCE were reduced most effectively with statin combined with UDCA. Combined therapy with statin and UDCA is recommended in patient with HCE and chronic liver diseases.
About the Authors
I. N. Grigorieva
Research Institute for Therapy, Siberian branch of Russian Academy of Medical Sciences,
Novosibirsk State Medical University
Russian Federation
Russian Federation
B.Bogatkova ul. 175/1, Novosibirsk, 630089
Krasnyi prospect 52, Novosibirsk, 630099
Y. M. Pozdnyakov
Moscow Regional Cardiologic Centre
Russian Federation
Frunze ul. 1, Moscow region, Zhukovski, 140180
Russian Federation
Frunze ul. 1, Moscow region, Zhukovski, 140180
References
1. Григорьева И.Н., Никитин Ю.П. Статины и желчнокаменная болезнь. Клиническая фармакология и терапия 2007;(1):66-70.
2. Alegret M., Silvestre J.S. Pleiotropic effects of statins and related pharmacological experimental approaches. Methods Find Exp Clin Pharmacol 2006;28(9):627–56.
3. Filippatos T.D., MikhailidisD.P. Lipid-lowering drugs acting at the level ofthe gastrointestinal tract. Curr Pharm Des 2009;15(5):490-516.
4. SmitJ.W., van Erpecum K.J., Stolk M.F. et al. Successful dissolution of cholesterol gallstone during treatment with pravastatin. Gastroenterology 1992;103(3):1068-70.
5. Bateson M.C. Simvastatin and ursodeoxycholic acid for rapid gallstone dissolution. Lancet 1990;336(8724): 1196-9.
6. Saunders K.D., Cates J.A., Abedin M.Z., Roslyn J.J. Lovastatin and gallstone dissolution: a preliminary study. Surgery 1993;113(1):28-35.
7. Abedin M.Z., Narins S.C., Park E.H. et al. Lovastatin alters biliary lipid composition and dissolves gallstones: a long-term study in prairie dogs. Dig Dis Sci 2002; 47(10):2192-210.
8. Sharma B.C., AgarwalD.K., Baijal S.S. et al. Pravastatin has no effect on bile lipid composition, nucleation time, and gallbladder motility in personswith normal levels of cholesterol.JClin Gastroenterol 1997;25(2):433-6.
9. SmitJ.W., van Erpecum K.J., Renooij W. et al. The effects ofthe 3-hydroxy, 3-methylglutaryl coenzyme A reductase inhibitor pravastatin on bile composition and nucleation of cholesterol crystals in cholesterol gallstone disease. Hepatology 1995;21(6):1523-9.
10. Jaeger H., Wilcox H.G., Bitterle T. et al. Intracellular supply of phospholipids for biliary secretion: evidence for a nonvesicular transport component. Biochem Biophys Res Commun 2000;268(3):790-7.
11. Sackmann М., Koelbl R., Paumgartner G. et al. Simvastatin added to ursodeoxycholic acid does not enhance disappearance of gallstone fragments after shock wave therapy. Z Gastroenterol 1995;33(10):585-9.
12. Molina M.T., Ruiz-Gutierrez V., Vazquez C.M. Intestinal resection and ursodeoxycholic acid: effect on hepatic 3-hydroxy-3-methylglutaryl coenzymeAreductase and acyl-CoA: cholesterol acyltransferase activities in the rat. Res Exp Med (Berl) 1997;196(6):381-7.
13. Angelin B., Ewerth S., Einarsson K. Ursodeoxycholic acid treatment in cholesterol gallstone disease: effects on hepatic 3-hydroxy-3-methylglutaryl coenzyme A reductase activity, biliary lipid composition, and plasma lipid levels. J Lipid Res 1983;24(4):461-8.
14. Maton P.N., EllisH.J.,Higgins M.J.,Dowling R.H. Hepatic HMG Co Areductase in human cholelithiasis: effects of chenodeoxycholic and ursodeoxycholic acids. Eur J Clin Invest 1980;10(4): 325-32.
15. Кобылина Е.Ю., Вахрушев Я.М. Применение симвастатина в сочетании с хофитолом на ранней стадии желчнокаменной болезни у пожилых. Эксп rлин uастроэнтрол.2008;(5): 11-5.
16. Драпкина О.М., Дуболазова Ю.В. Статины и печень: тупик или новые горизонты? РМЖ 2009;17(4):210-5.
17. Argo C.K., Loria P., Caldwell S.H., LonardoA. Statins in liver disease: a molehill, an iceberg, or neither? Hepatology 2008;48(2):662–9.
18. Kiyici M., Gulten M., Gurel S., еt аl. Ursodeoxycholic acid and atorvastatin in the treatment of nonalcoholic steatohepatitis. Can J Gastroenterol 2003;17(12):713-8.
19. Georgescu E.F., Georgescu M. Therapeutic options in non-alcoholic steatohepatitis (NASH). Are all agents alike? Results of a preliminary study. J Gastrointest Liver Dis 2007;16(1):39-46.
20. Okada K., Shoda J., Taguchi K., et al. Ursodeoxycholic acid stimulates Nrf2-mediated hepatocellulartransport, detoxification, and antioxidative stress systems in mice. Am J Physiol Gastrointest Liver Physiol 2008;295(4):G735-47.
21. Habeos I.G., Ziros P.G., ChartoumpekisD. et al. Simvastatin activates Keap1/Nrf2 signaling in rat liver. J Mol Med 2008;86(11):1279-85.
22. NelsonA., TorresD.M., MorganA.E. еt аl.Apilot study using simvastatin in the treatment of nonalcoholic steatohepatitis: A randomized placebo-controlled trial. J Clin Gastroenterol 2009;43(10):990-4.
23. Звенигородская Л.А., Лазебник Л.Б., Черкашова Е.А., Ефремов Л.И. Статиновый гепатит. Трудный пациент 2009;(4-5):44-9.
24. Звенигородская Л.А., Мельникова Н.В. Гиполипидемическая терапия у больных с неалкогольной жировой болезнью печени: место гепатопротекторов. Гастроэнтерология. Приложение к журналу Consilium Medicum 2009;(1):32-6.
25. RahierJ.F.,RahierJ., LeclercqI.,GeubelA.P. Severe acute cholestatic hepatitiswithprolongedcholestasis and bile-duct injury following atorvastatin therapy: a case report. Acta Gastroenterol Belg 2008;71(3):318-20.
26. Корнеева О.Н., Драпкина О.М. Урсодезоксихолевая кислота и статины в лечении метаболического синдрома. Российские медицинские вести 2007;(3):76-9.
27. Буеверова Е.Л., Драпкина О.М. Методы коррекции дислипидемии у больных с метаболическим синдромом. Российские медицинские вести. 2008;(4):3-10.
28. Dimoulios P.,Kolios G., Notas G. et al. Ursodeoxycholic acid reduces increased circulating endothelin 2 in primary biliary cirrhosis. Aliment Pharmacol Ther 2005;21(3):227-34.
29. Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. В: Оганов Р.Г., редактор. Национальные клинические рекомендации. М.: Силице Полиграф; 2009. С. 19-102.
30. Cabezas Gelabert R. Effect of ursodeoxycholic acid combinedwith statins in hyperchole-sterolemia treatment: a prospective clinical trial (in Spanish). Rev Clin Esp 2004;204(12):632-5.
31. Okamoto S., Nakano K., Kosahara K. Effects of pravastatin and ursodeoxycholic acid on cholesterol and bile acid metabolism in patients with cholesterol gallstones. J Gastroenterol 1994;29(1):47-55.
32. Neuvonen P.J., Backman J.T., Niemi M. Pharmacokinetic comparison of the potential over–the– counter statins simvastatin, lovastatin, fluvastatin and pravastatin. Clin Pharmacokinet 2008;47(7):463-474.
33. Becquemont L., Glaeser H., Drescher S. еt аl. Effects of ursodeoxycholic acid on P-glycoprotein and cytochrome P450 3A4-dependent pharmacokinetics in humans. Clin Pharmacol Ther 2006;79(5):449-60.
34. He Y.J., Zhang W., Tu J.H. еt аl. Hepatic nuclear factor 1alpha inhibitor ursodeoxycholic acid influences pharmacokinetics ofthe organic anion transporting polypeptide1B1substrate rosuvastatin and bilirubin. Drug Metab Dispos 2008;36(8):1453-6.
Review
For citations:
Grigorieva I.N., Pozdnyakov Y.M. STATINS AND URSODEOXYCHOLIC ACID: COOPERATION OR NEUTRALITY? Rational Pharmacotherapy in Cardiology. 2009;5(6):51-54. (In Russ.) https://doi.org/10.20996/1819-6446-2009-5-6-51-54
Views:
4036
.jpg)
Email this article 