Possibilities of ademetionine in treatment of patients with alcoholic liver disease

Abstract

Introduction. Alcoholic liver disease (ALD) is the most common liver disease, the terminal stage of which is alcoholic liver cirrhosis (ALC), which ranks first in terms of prevalence and frequency of lethal outcomes in hospital patients. The pathogenesis of alcoholic liver disease is based on direct damage to the hepatocyte membrane, oxidative stress, hepatic parenchyma inflammation with hyperproduction of inflammatory mediators, immune mechanisms, hepatic parenchyma fibrosis. S-adenosyl-L-methionine (ademetionine) is able to affect the different parts of the pathogenesis of ALD. One of the new ademetionine drugs is Samelix (manufacturer – Canonfarma Production JSC, Russia).Aim of the study. Evaluation of Samelix efficacy and safety in patients with chronic alcoholic liver disease with cholestasis syndrome at the inpatient stage of treatment.Materials and methods. 23 patients (men – 11, women – 12) were admitted to the study. The average age was 51.8 ± 3.4 years. Duration of the disease in the remaining patients averaged 3.5 ± 1.9 years (from 0.5 to 8 years). All patients received detoxification therapy, vitamin therapy, and Verospiron was used in patients with liver cirrhosis. Within 10-12 days the therapy with Samelix was carried out: 800 mg/day intravenous drip. The dynamics of biochemical indices (ALT, AST, GGT, bilirubin, ALP); clinical manifestations; life quality according to the SF-36 questionnaire; side effects were assessed.Conclusions. There was a significant reduction in the number of patients with skin itching, increased fatigue and depressed mood, positive dynamics of biochemical indicators in the form of a decrease in AST, ALT, alkaline phosphatase, GGT, total and direct bilirubin. Thus, the therapy allows to effectively reduce symptoms in patients with alcoholic liver disease, resulting in an improvement on all scales and summary indicators – psychological and physical component of health.