Is There Any Vindication for Low Dose Nonselective β-blocker Medication in Patients with Liver Cirrhosis?

Overview

Journal Clin Mol Hepatol

Specialty Gastroenterology

Date 2012 Aug 16

PMID 22893871

Citations 7

Authors

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

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Non-selective beta-blockers and the incidence of hepatocellular carcinoma in patients with cirrhosis: a meta-analysis.

He X, Zhao Z, Jiang X, Sun Y Front Pharmacol. 2023; 14:1216059.

PMID: 37538177 PMC: 10394622. DOI: 10.3389/fphar.2023.1216059.

Antitumor Effects and Mechanisms of Metabolic Syndrome Medications on Hepatocellular Carcinoma.

Oura K, Morishita A, Tani J, Masaki T J Hepatocell Carcinoma. 2022; 9:1279-1298.

PMID: 36545268 PMC: 9760577. DOI: 10.2147/JHC.S392051.

Association Between Nonselective Beta-Blocker Use and Hepatocellular Carcinoma in Patients With Chronic Hepatitis B Without Cirrhosis and Decompensation.

Cheng H, Lin H, Lin H, Uang Y, Keller J, Wang L Front Pharmacol. 2022; 12:805318.

PMID: 35069216 PMC: 8777254. DOI: 10.3389/fphar.2021.805318.

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.

Li T, Tsai Y, Hsu C, Liu C, Huang C, Yang Y Gastroenterol Res Pract. 2020; 2020:1892584.

PMID: 32454812 PMC: 7238337. DOI: 10.1155/2020/1892584.

Propranolol reduces systemic oxidative stress and endotoxemia in cirrhotic patients with esophageal varices.

Taprantzi D, Zisimopoulos D, Thomopoulos K, Spiliopoulou I, Georgiou C, Tsiaoussis G Ann Gastroenterol. 2018; 31(2):224-230.

PMID: 29507470 PMC: 5825953. DOI: 10.20524/aog.2017.0222.

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