Study summary · research use only
Afamelanotide Is Associated with Dose-Dependent Protective Effect from Liver Damage Related to Erythropoietic Protoporphyria
Plain-language summary
Paraphrased from the published abstract below — not a verdict on whether anything works.
This retrospective observational study in human patients with erythropoietic protoporphyria (EPP) examined afamelanotide, a controlled-release α-MSH analog implant applied every sixty days, using 2933 liver-function tests, 1186 protoporphyrin (PPIX) concentrations, and 1659 afamelanotide implant applications from 70 EPP patients. The authors report that PPIX levels increased significantly with more days since the last afamelanotide implant (p < 0.0001), and that ALAT and bilirubin decreased significantly with a greater number of afamelanotide doses in the preceding 365 days (p = 0.012 and p = 0.0299, respectively), while global radiation was associated only with PPIX (p = 0.0113). The authors describe these findings as suggesting a dose-dependent association between afamelanotide and PPIX concentrations and liver function tests in EPP.
Abstract
In animal models, melanocyte-stimulating hormones (MSHs) protect the liver from various injuries. Erythropoietic protoporphyria (EPP), a metabolic disorder, leads to the accumulation of protoporphyrin (PPIX). In addition to the most prominent symptom of incapacitating phototoxic skin reactions, 20% of EPP patients exhibit disturbed liver functioning and 4% experience terminal liver failure caused by the hepatobiliary elimination of excess PPIX. Skin symptoms are mitigated through the application of the controlled-release implant afamelanotide, an α-MSH analog, every sixty days. Recently, we showed that liver function tests (LFTs) improved during afamelanotide treatment when compared to before treatment. The present study investigated whether this effect is dose-dependent, as the evidence of dose dependency would support a beneficial influence of afamelanotide. In this retrospective observational study, we included 2933 liver-function tests, 1186 PPIX concentrations and 1659 afamelanotide implant applications in 70 EPP patients. We investigated whether the number of days since the preceding afamelanotide dose or the number of doses during the preceding 365 days had an effect on LFTs and PPIX levels. In addition, we assessed the effect of global radiation. Inter-patient differences exerted the most prominent effect on PPIX and LFTs. In addition, PPIX increased significantly with an increase in the number of days since the last afamelanotide implant (p < 0.0001). ALAT and bilirubin decreased significantly with an increasing number of afamelanotide doses in the preceding 365 days (p = 0.012, p = 0.0299, respectively). Global radiation only influenced PPIX (p = 0.0113). These findings suggest that afamelanotide ameliorates both PPIX concentrations and LFTs in EPP in a dose-dependent manner.
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