Efficacy and safety of glycyrrhizin preparations in treating anti-tuberculosis drug-induced liver injury:a Meta-analysis
YANG Xiaoming
CHENH Anlan
YANG Yanjie
GUO Yanling
JIANG Hongwei
WANG Yuejiao
LI Lei
XU Guiru
Abstract：Objective To systematically evaluate the efficacy and safety of different glycyrrhizin drugs in the treatment of anti-tuberculosis drug-induced liver injury(AT-DILI).Methods Randomized controlled trials(RCTs)investigating glycyrrhizin preparations for AT-DILI were retrieved from domestic and international medical literature databases.After screening the literature,the quality of the studies was evaluated,and a meta-analysis was conducted using RevMan 5.3 software.Results A total of 13 RCTs involving 1,435 patients were included.Meta-analysis showed clinical effective rate in magnesium isoglycyrrhizinate(MI)group was significantly higher than that of other glycyrrhizin agents group[OR=4.57,95%CI:2.93-7.12,P=0.000].Conversely,compound glycyrrhizin(CG)group was significantly lower than other glycyrrhizin drugs group[OR=0.37,95%CI:0.24-0.57,P=0.000].Subgroups analysis showed that no significant differences were found between diammonium glycyrrihizinate(DG)and compound ammonium glycyrrhizin(CAG)group.Comparison of therapeutic efficacy of four glycyrrhizin agents showed MI＞DG,CAG＞CG,and DG is close to CAG.Regarding liver function indicators,MI significantly reduced alanine aminotransferase(ALT)and total bilirubin levels more than other glycyrrhizin preparations[MD=-21.63,95%CI:-32.03--11.23),P=0.000],[MD=-11.07,95%CI:-20.81--1.34),P=0.030],but had no significant effect on aspartate aminotransferase(AST)levels.And there were no significant differences in the incidence of adverse reactions among 4 groups.Conclusions Magnesium isoglycyrrhizinate(MI)demonstrates superior efficacy in terms of treatment response rate and reduction of ALT and TB levels compared to other glycyrrhizin preparations(CG,DG,CAG)for AT-DILI,while exhibiting comparable safety.Comparison of therapeutic efficacy of four glycyrrhizin preparations indicated MI＞DG≈CAG＞CG.
Keywords：magnesium isoglycyrrhizinatecompound glycyrrhizindrug-induced liver damageanti-tuberculosis agentsefficacysafetymeta analysis
Publication Date：2025-08-30
Online Publishing Date：2025-08-28(First online date of this platform, not the publication date of the document)
Pages：7( 326-332 )