Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2018.59.298
Liver damage indices as a tool for modifying methadone maintenance treatment: a cross-sectional study
Željko Ključević
; Public Health Institute of Split-Dalmatia County, Split, Croatia
Benjamin Benzon
; Department of Anatomy, Histology, and Embryology, University of Split School of Medicine, Split, Croatia
Nikola Ključević
; Department of Anatomy, Histology, and Embryology, University of Split School of Medicine, Split, Croatia
Maja Veršić Bratinčević
; Department of Forensic Medicine University of Split School of Medicine, Split, Croatia
Davorka Sutlović
; Department of Pathology, Forensic Medicine and Cytology, University Hospital Center Split, Split, Croatia
Sažetak
Aim To assess the effect of liver damage on methadone
metabolism in opiate addicts undergoing methadone
maintenance treatment (MMT).
Methods This cross-sectional study recruited 74 patients
treated at the outpatient clinic of Public Health Institute
of Split-Dalmatia County from 2013-2016. Concentrations
of methadone and its main inactive metabolite were measured
in participants’ biological samples on regular checkups.
Urine samples obtained before oral methadone intake,
and blood and urine samples obtained 90 minutes
after methadone intake were analyzed using gas chromatography/
mass spectrometry. Participants were divided
into groups according to liver damage criteria: hepatitis C
virus status (positive, negative, or clinical remission); aspartate
aminotransferase to platelet ratio (APRI) index (<0.7
and ≥0.7); and fibrosis-4 score (<1.45, 1.45-3.25, >3.25).Results Metabolic ratio and methadone metabolite concentration
in plasma decreased linearly with HCV infection
status by the factor of 1.67 (P = 0.001) and 2.2 (P = 0.043), respectively.
Metabolic ratio in plasma decreased in patients
with APRI index ≥0.7 by the average factor of 2.12 (P = 0.01)
and methadone metabolite concentration in plasma decreased
by the factor of 6.16 (P = 0.009). Metabolic ratio
in urine decreased with the severity of fibrosis-4 score by
the average factor of 1.63 (P = 0.008), whereas methadone
metabolite concentration decreased by the factor of 3.53
(P = 0.007).
Conclusion Liver damage decreases methadone metabolism.
Indices of liver function should be calculated regularly
during MMT for methadone dose titration.
Ključne riječi
Hrčak ID:
239201
URI
Datum izdavanja:
16.12.2018.
Posjeta: 630 *