hepatologie 2019 curriculum innere medizin 2015 · curriculum innere medizin 2015 hepatologie 2019...
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Curriculum
Innere Medizin 2015Hepatologie 2019
Christian Ruis – Gastroenterologie – Spital Thun
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Christian Ruis – Gastroenterologie – Spital Thun | 2
PBC - Primär Biliäre Cholangitis
- Früher: Primär Biliäre Cirrhose
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Primär Biliäre Cholangitis
- Bisher Therapie mit Ursodesoxycholsäure
Poupon RE, Poupon R, Balkau B, and the UDCA-PBC Study Group, N Engl J Med 1994; 330:1342
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NEJM 08/2016, POISE-Studie
- Preis
- Juckreiz
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NEJM 07/2018, BEZURSO-Studie
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Bezafibrat – PPAR-Agonist
( agonists of peroxisome proliferator–activated receptors)
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BEZURSO
UDC + Placebo < > UDC + Bezafibrat 400 mg/d
- 24 Monate -
Unzureichendes Ansprechen auf Ursodesoxycholsäure bei PBC
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Normalisierung Leberwerte / Bilirubin
Normale AP 67 % vs. 2 %
Fibroscan - 15 % vs. + 22 %
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Sicherheit
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Fettlebererkrankung
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Gene für NAFLD und ALD
Buch et al., Nature Genetics 2015, Kozlitina et. al. Nature Genetics 2014
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Risikogene für Fettleber
Buch et al., unpublished data