Effect of Wuzhi Capsules on blood concentration and pharmacokinetics of tacrolimus in recipients of liver transplantation:a Meta-analysis
Objective The effect of the Wuzhi Capsules on the plasma concentration,pharmacokinetic parameters of tacrolimus(TAC),and liver and kidney function were systematically evaluated.Methods In major Chinese and English databases both do mestically and internationally,a systematic search was conducted on randomized controlled trials(RCTs)and prospective self-control studies of TAC combined with Wuzhi Capsules in the treatment of liver transplant recipients.The search deadline was as of January 2023.Two rese archers independently completed research retrieval,data extraction,and methodological quality evaluation based on the inclusion and exclusion criteria of the research literature.Meta analysis was conducted on the blood drug concentration,liver and kidney function,and pharmacokinetic parameters of TAC i n liver transplant recipients after the combined application of Wuzhi Capsules.Results Eight articles were finally included,for a total of 381 liver transplant recipients.Meta-analysis results:compared with no combined Wuzhi Capsules,① after 1 month and 2 months of TAC combined with the Wuzhi Capsules,the plasma concentration of TAC in liver transplant recipients were[SMD= 0.83,95%CI(0.34,1.31),P= 0.000 8],[SMD= 0.57,95%CI(0.17,0.97),P=0.005],respectively,the difference is statistically significant;There was no significant difference after 3 months and 6 months;②pharmacokinetic parameters:after combining Wuzhi Capsules,area under curve(AUC0→t)of TAC in liver transplant recipients was[SMD = 1.97,95%CI(1.27,2.66),P＜0.000 01],peak time(Tmax)was[SMD=-0.85,95%CI(-1.45,-0.25),P= 0.005],peak concentration(Cmax)was[SMD=1.79,95%CI(0.82,2.75),P=0.000 3],the differences were all statistically significant;③after combining TAC and Wuzhi Capsules,alanine aminotransferase(ALT)was[SMD=-1.03,95%CI(-1.80,-0.25),P=0.010],with significant difference.There was no significant difference in total bilirubin(TB)and serum creatinine(Cr).Conclusion Liver transplant recipients received TAC-based related immunosuppression regimen in combination with the use of Wuzhi Capsules can achieve higher plasma concentration of TAC in the early stage of medication,and long-term medication does not affect the steady-state concentration of TAC in liver transplant recipients.In addition,combining Wuzhi Capsules can improve liver function in liver transplant recipients to some extent without affecting renal function and bile excretion.In terms of pharmacokinetics,Wuzhi Capsules can improve the bioavailability and safety of TAC.Limited to the quality and quantity of the included studies,the above conclusions still need further research and support.
万方数据
