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"Tae Wan Kim"

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"Tae Wan Kim"

Original Article

Liver fibrosis, cirrhosis, and portal hypertension

Is there any vindication for low dose nonselective β-blocker medication in patients with liver cirrhosis?
Tae Wan Kim, Hong Joo Kim, Chang Uk Chon, Hyun Sun Won, Jung Ho Park, Dong Il Park, Yong Kyun Cho, Chong Il Sohn, Woo Kyu Jeon, Byung Ik Kim
Korean J Hepatol 2012;18(2):203-212.
Published online June 26, 2012
DOI: https://doi.org/10.3350/cmh.2012.18.2.203
Background/Aims

Nonselective β-blockers (NSBBs), such as propranolol, reportedly exert a pleiotropic effect in liver cirrhosis. A previous report suggested that survival was higher in patients receiving adjusted doses of NSBBs than in ligation patients. This study investigated whether low-dose NSBB medication has beneficial effects in patients with liver cirrhosis, especially in terms of overall survival.

Methods

We retrospectively studied 273 cirrhotic patients (199 males; age 53.6±10.2 years, mean±SD) who visited our institution between March 2003 and December 2007; follow-up data were collected until June 2011. Among them, 138 patients were given a low-dose NSBB (BB group: propranolol, 20-60 mg/day), and the remaining 135 patients were not given an NSBB (NBB group). Both groups were stratified randomly according to Child-Turcotte-Pugh (CTP) classification and age.

Results

The causes of liver cirrhosis were alcohol (n=109, 39.9%), hepatitis B virus (n=125, 45.8%), hepatitis C virus (n=20, 7.3%), and cryptogenic (n=19, 7.0%). The CTP classes were distributed as follows: A, n=116, 42.5%; B, n=126, 46.2%; and C, n=31, 11.4%. Neither the overall survival (P=0.133) nor the hepatocellular carcinoma (HCC)-free survival (P=0.910) differed significantly between the BB and NBB groups [probability of overall survival at 4 years: 75.1% (95% CI=67.7-82.5%) and 81.2% (95% CI=74.4-88.0%), respectively; P=0.236]. In addition, the delta CTP score did not differ significantly between the two groups.

Conclusions

Use of low-dose NSBB medication in patients with liver cirrhosis is not indicated in terms of overall and HCC-free survival.

Citations

Citations to this article as recorded by  Crossref logo
  • Non-selective beta-blockers and the incidence of hepatocellular carcinoma in patients with cirrhosis: a meta-analysis
    Xinyi He, Zimo Zhao, Xi Jiang, Yan Sun
    Frontiers in Pharmacology.2023;[Epub]     CrossRef
  • Association Between Nonselective Beta-Blocker Use and Hepatocellular Carcinoma in Patients With Chronic Hepatitis B Without Cirrhosis and Decompensation
    He-Yun Cheng, Hsiu C. Lin, Hsiu L. Lin, Yow S. Uang, Joseph J. Keller, Li H. Wang
    Frontiers in Pharmacology.2022;[Epub]     CrossRef
  • Antitumor Effects and Mechanisms of Metabolic Syndrome Medications on Hepatocellular Carcinoma
    Kyoko Oura, Asahiro Morishita, Joji Tani, Tsutomu Masaki
    Journal of Hepatocellular Carcinoma.2022; Volume 9: 1279.     CrossRef
  • Low dose of propranolol treatment is associated with better survival in cirrhotic patients with hepatic encephalopathy
    Pei-Chang Lee, Yu-Ju Chen, Yueh-Ching Chou, Kuei-Chuan Lee, Ping-Hsien Chen, Wei-Yu Kao, Yi-Hsiang Huang, Teh-Ia Huo, Han-Chieh Lin, Ming-Chih Hou, Fa-Yauh Lee, Jaw-Ching Wu, Chien-Wei Su
    European Journal of Gastroenterology & Hepatology.2020; 32(3): 365.     CrossRef
  • Propranolol Is Associated with Lower Risk of Incidence of Hepatocellular Carcinoma in Patients with Alcoholic Cirrhosis: A Tertiary-Center Study and Indirect Comparison with Meta-Analysis
    Tzu-Hao Li, Yu-Lien Tsai, Chien-Fu Hsu, Chih-Wei Liu, Chia-Chang Huang, Ying-Ying Yang, Hung-Cheng Tsai, Shiang-Fen Huang, Yun-Cheng Hsieh, Hsuan-Miao Liu, Tzung-Yan Lee, Ming-Chih Hou, Chang-Youh Tsai, Han-Chieh Lin
    Gastroenterology Research and Practice.2020; 2020: 1.     CrossRef
  • Effect of Propranolol Treatment on the Incidence of Hepatocellular Carcinoma in Patients Waiting for Liver Transplant With Cirrhosis: A Retrospective, Surveillance Study in a Tertiary Center
    Nuretdin Suna, Diğdem Özer Etik, Serkan Öcal, Haldun Selçuk
    Experimental and Clinical Transplantation.2019; 17(5): 632.     CrossRef
  • Does Angiotensin‐Converting Enzyme Inhibitor and β‐Blocker Use Reduce the Risk of Primary Liver Cancer? A Case–Control Study Using the UK Clinical Practice Research Datalink
    Katrina Wilcox Hagberg, Vikrant V. Sahasrabuddhe, Katherine A. McGlynn, Susan S. Jick
    Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy.2016; 36(2): 187.     CrossRef
  • The use of β-blockers is associated with a lower risk of developing hepatocellular carcinoma in patients with cirrhosis
    Iván Herrera, Sonia Pascual, Pedro Zapater, Fernando Carnicer, Pablo Bellot, José María Palazón
    European Journal of Gastroenterology & Hepatology.2016; 28(10): 1194.     CrossRef
  • Non‐selective beta‐blockers may reduce risk of hepatocellular carcinoma: a meta‐analysis of randomized trials
    Maja Thiele, Agustín Albillos, Rozeta Abazi, Reiner Wiest, Lise L. Gluud, Aleksander Krag
    Liver International.2015; 35(8): 2009.     CrossRef
  • Management of Hepatocellular Carcinoma in Cirrhotic Patients with Portal Hypertension: Relevance of Hagen-Poiseuille's Law
    Gerond Lake-Bakaar, Muneeb Ahmed, Amy Evenson, Alan Bonder, Salomao Faintuch, Vinay Sundaram
    Liver Cancer.2014; 3(3-4): 428.     CrossRef
  • Can non-selective beta-blockers prevent hepatocellular carcinoma in patients with cirrhosis?
    Maja Thiele, Reiner Wiest, Lise Lotte Gluud, Agustín Albillos, Aleksander Krag
    Medical Hypotheses.2013; 81(5): 871.     CrossRef
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