scholarly journals Anticoagulant in Patients with Pulmonary Embolism and Fatty Liver: A Case Report

2020 ◽  
Author(s):  
Sha-Sha Li ◽  
Wei-Xian Lin ◽  
Kun-Yu Huang ◽  
Sheng-Yang Chen ◽  
Juan Chen ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Liver Disease ◽  
Fatty Liver ◽  
Sequential Therapy ◽  
Low Molecular Weight ◽  
Test Results ◽  
Efficacy And Safety ◽  
Routine Test ◽  
Bleeding Events ◽  
Blood Routine Test

Abstract AIMS: Patients with liver disease are more prone to thrombosis and bleeding events than healthy people. The decision to use anticoagulation in patients with pulmonary embolism and liver disease requires a cautious evaluation of the risks of bleeding and the benefits of anticoagulation. In order to make a recommendation for patient with fatty liver that developed pulmonary embolism, we reported this case. METHODS: In this paper, we reported a case of a patient with fatty liver that developed pulmonary embolism. The low molecular weight heparin sodium injection and different anticoagulants were evaluated for this patient.RESULTS: After evaluating the efficacy and safety of different anticoagulants in patients with pulmonary embolism and liver dysfunction, rivaroxaban is more suitable for this patient to be treated by sequential therapy. After three weeks of treatment with rivaroxaban, the patient’s blood routine test results were normal, and no side effect was found. CONCLUSIONS: For patients with pulmonary embolism and fatty liver, maybe NOAC is more suitable.

scholarly journals Sequential Therapy of LMWH and Rivaroxaban in the Initial Treatment of Patients With Acute Pulmonary Embolism

2021 ◽  
Author(s):  
Wei Xiong ◽  
Yunfeng Zhao ◽  
He Du ◽  
Yanmin Wang ◽  
Xuejun Guo ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Initial Treatment ◽  
Acute Pulmonary Embolism ◽  
Sequential Therapy ◽  
Hemodynamic Instability ◽  
Efficacy And Safety ◽  
Bleeding Events ◽  
Once Daily ◽  
Number Of Patients

Abstract Background: Sequential low molecular weight heparin(LMWH) plus warfarin, LMWH plus edoxaban as well as LMWH plus dabigatran regimens have already showed efficacy and safety in the treatment of acute pulmonary embolism(PE). The efficacy and safety of sequential LMWH plus rivaroxaban regimen in the treatment of PE has been understudied. Methods: A retrospective study was performed to explore the efficacy and safety of sequential therapy regimens of subcutaneous LMWH( nadroparin 4100 IU every 12 hours for a week) followed by oral rivaroxaban(20mg once daily for 3 months) in the management of patients with established acute PE without hemodynamic instability, compared with those of LMWH plus dabigatran as well as LMWH plus warfarin.Results: The number of patients with total resolution of PE were 238(80.1%), 220(78.0%) and 166(62.6%), in the LMWH+rivaroxaban, LMWH+dabigatran, and LMWH+warfarin groups, respectively. (P=0.001) The prevalence of DVT at the 3-month follow-up visit were 18(6.1%), 14(5.0%) and 11(4.2%), in the aforementioned three groups, respectively.(P=0.559) The NT-proBNP level (pg/mL) at the 3-month follow-up visit were 122.5(97.4-158.9) , 131.7(102.2-166.3), and 357.8(275.4-433.2) in three groups, respectively.(P=0.001) The D-dimer level (ng/mL) at the 3-month follow-up visit were 387.3(310.9-465.2) , 432.5(382.4-489.6), and 854.0(721.5-993.7) in three groups, respectively.(P<0.001) The number of patients with major bleeding events were 3(0.9%), 6(1.8%), and 18(5.5%) in three groups, respectively. (P<0.001)Conclusions: The regimen of sequential subcutaneous LMWH for a week followed by oral rivaroxaban at a dose of 20mg once daily for three months is effective and safe in the initial treatment of patients with acute pulmonary embolism.

Efficacy and Safety of a Fixed Combination of Glycyrrhizic Acid and Essential Phospholipids in Non-Alcoholic Fatty and Alcoholic Liver Disease: Results from Randomized Placebo-Controlled Trials

2021 ◽  
Vol 76 (6) ◽  
pp. 595-603
Author(s):  
Igor V. Maev ◽  
Alexey O. Bueverov ◽  
Artem V. Volnukhin
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Alcoholic Liver Disease ◽  
Fatty Liver Disease ◽  
Glycyrrhizic Acid ◽  
Fixed Combination ◽  
Efficacy And Safety ◽  
Alcoholic Fatty Liver ◽  
Essential Phospholipids ◽  
Alcoholic Fatty Liver Disease

Background. Drug treatment of non-alcoholic fatty and alcoholic liver disease remains an urgent, unsolved problem. Due to the commonality of many pathogenetic mechanisms and predictors of progression, a universal approach to the search for a therapeutic agent can be considered. Aims pooled analysis of the results of two multicenter, randomized, double-blind, placebo-controlled studies of a fixed combination of glycyrrhizic acid and essential phospholipids in two dosage forms to study its efficacy and safety in non-alcoholic fatty and alcoholic liver disease, in the presence and absence of predictors of disease progression. Methods. The pooled analysis included 180 patients with non-alcoholic fatty liver disease (Gepard study) and 120 patients with alcoholic liver disease (Jaguar study). Patients of the main group received a fixed combination of 5.0 g intravenous jet 3 times a week for the first 2 weeks; then 2 capsules 3 times a day for the next 10 weeks. Patients in the control group received placebo according to the same scheme. The total duration of treatment was 12 weeks in the Gepard study (1 course of stepwise therapy) and 24 weeks in the Jaguar study (2 courses of stepwise therapy). A comparative analysis of the efficacy and safety of a fixed combination and a placebo was carried out, in the presence and absence of predictors of progression, separately for each nosology and in a mixed sample. Results. In patients with non-alcoholic fatty and alcoholic liver disease who received the fixed combination, in contrast to the placebo group, there was a statistically more significant decrease in the level of biochemical markers of inflammation alanine aminotransferase, aspartate aminotransferase, adiponectin, and the value of the AktiTest index. There was no negative trend in the NAFLD fibrosis score; more significant positive dynamics of FibroTest is shown. Predictors of disease progression hyperglycemia, hyperlipidemia, age did not have a negative impact on the results in the study group. The efficacy of the study drug was noted in patients with non-alcoholic fatty liver disease and normal body weight; data were obtained indicating its possible effectiveness with a high activity of the inflammatory process associated with alcoholic liver damage. The frequency of adverse events in the study and control groups was comparable. Conclusions. Based on a generalized analysis of the results of two studies, promising directions for the study and use of a fixed combination of glycyrrhizic acid and essential phospholipids were identified: non-alcoholic fatty liver disease without obesity, alcoholic steatohepatitis of high activity (as an adjuvant); steatohepatitis of non-alcoholic and alcoholic etiology, combined with hyperglycemia and hyperlipidemia.

scholarly journals Efficacy and safety of incretin-based therapies in patients with nonalcoholic fatty liver disease

Medicine ◽  
2020 ◽  
Vol 99 (27) ◽  
pp. e20695
Author(s):  
Si-min Fan ◽  
Xiao-yan Shi ◽  
Yan-ping Fan ◽  
Lin-lin Yang ◽  
Jia Yao ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Efficacy And Safety ◽  
Nonalcoholic Fatty Liver
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