A systematic review on the prevention and treatment of antituberculous drug-induced liver injury by hepatoprotective drugs
Objective:To evaluate the methodological quality and outcome indexes of systematic evaluation of anti-tuberculosis drug-induced liver injury(ATB-DILI)prevention and treatment,so as to provide reference for clinical drug use and clinical research.Methods:By searching The Cochrane Library,EMBASE,PubMed,CNKI,CBM VIP and WF databases,systematic review literatures meeting the inclusion criteria were screened.Subject words and free words were used to search,and the search time was from the establishment of the database to January 30,2023.The methodological quality of the included systematic review literature was evaluated using the AMSTAR 2 scale,and the evidence quality of the included outcome indicators was graded using the GRADE tool.Results:A total of 12 systematic reviews in both Chinese and English were included,six of which compared the incidence of liver injury between the prophylactic hepatoprotective drug group and the control group(with or without placebo)during standard anti-tuberculosis therapy.Another six systematic reviews compared the clinical efficacy of therapeutic use of a hepatoprotective drug in patients with ATB-DILI with those of controls(blank control or other hepatoprotective drugs,etc).The AMSTAR 2 quality rating showed that 11 articles were of very low quality and 1 was of low quality,among which the critical items with major defects were 2 and 7,and the non-critical items were 3,15 and 16.GRADE evidence evaluation showed that among 41 outcome indicators included in 12 systematic evaluations,there were 8 evidence of intermediate quality,16 evidence of low quality,17 evidence of very low quality and no evidence of high quality.Conclusion:The existing evidence suggests that prophylacticapplicationof hepatoprotective drugs in anti-tuberculosis therapy can reduce the occurrence of liver injury,and therapeutic application of some Western Medical insurance liver drugs and Chinese herbal compound can improve the liver function of ATB-DILI patients,with obvious efficacy and short-term safety.However,the methodological quality of the included literature and the evidence level of the conclusions are low,so it is necessary to strengthen the methodological quality and evidence quality of the systematic evaluation.
anti-tuberculosis drug-induced liver injuryhepatoprotective drugssystematic reviewoverview of systematic reviewsAMSTAR 2
NETL
NSTL
万方数据
维普
