Document Detail


The effects of angiotensin blocking agents on the progression of liver fibrosis in the HALT-C Trial cohort.
MedLine Citation:
PMID:  21136163     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Therapies that can slow the progression of liver fibrosis in chronic liver disease are needed. Evidence suggests that the renin-angiotensin system (RAS) contributes to inflammation and fibrosis in chronic liver disease. Both animal and limited human studies have shown that RAS inhibition with angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor-1 [AT-1] blockers (ARBs) has antifibrogenic properties.
AIMS: In this study, we evaluated the effects of continuous ACEi/ARB use for 3.5 years on histological liver fibrosis progression in the HALT-C Trial cohort.
METHODS: In the HALT-C Trial, subjects with chronic hepatitis C and advanced hepatic fibrosis (Ishak stage ≥3) underwent serial liver biopsies at baseline, 1.5 years, and 3.5 years after randomization. The primary outcome was a ≥2-point increase in Ishak fibrosis score in at least one of the two serial biopsies. Sixty-six subjects were continuously taking ACEi/ARBs over the observation period, 126 were taking other antihypertensive medications, and 343 subjects took no antihypertensive medications.
RESULTS: The three groups were similar in baseline fibrosis scores, and the two groups being treated with antihypertensives were taking a similar number of antihypertensive medications. Fibrosis progression occurred in 33.3% of the ACEi/ARB group, 32.5% of the other antihypertensive medications group, and in 25.7% of subjects taking no antihypertensive medications. No significant associations between ≥2-point increases in fibrosis scores and continuous ACEi/ARB use were apparent at either 1.5 or 3.5 years in diabetes-adjusted and unadjusted odds ratios.
CONCLUSIONS: ACEi/ARB therapy did not retard the progression of hepatic fibrosis.
Authors:
Barham K Abu Dayyeh; May Yang; Jules L Dienstag; Raymond T Chung
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-12-07
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  56     ISSN:  1573-2568     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-28     Completed Date:  2011-03-11     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  564-8     Citation Subset:  AIM; IM    
Affiliation:
Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. babudayyeh@partners.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Angiotensin Receptor Antagonists / therapeutic use*
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Female
Hepatitis C, Chronic / complications*
Humans
Liver Cirrhosis / etiology,  prevention & control*
Male
Middle Aged
Grant Support
ID/Acronym/Agency:
1 UL1 RR 025780-01/RR/NCRR NIH HHS; 1 UL1 RR024982-01/RR/NCRR NIH HHS; 1 UL1 RR024986/RR/NCRR NIH HHS; 1 UL1 RR025758-01/RR/NCRR NIH HHS; K24 DK078772-03/DK/NIDDK NIH HHS; K24 DK078772-05/DK/NIDDK NIH HHS; M01RR-00042/RR/NCRR NIH HHS; M01RR-00043/RR/NCRR NIH HHS; M01RR-00051/RR/NCRR NIH HHS; M01RR-00065/RR/NCRR NIH HHS; M01RR-00633/RR/NCRR NIH HHS; M01RR-00827/RR/NCRR NIH HHS; M01RR-01066/RR/NCRR NIH HHS; M01RR-06192/RR/NCRR NIH HHS; N01 DK092318/DK/NIDDK NIH HHS; N01 DK092319/DK/NIDDK NIH HHS; N01 DK092320/DK/NIDDK NIH HHS; N01 DK092321/DK/NIDDK NIH HHS; N01 DK092322/DK/NIDDK NIH HHS; N01 DK092323/DK/NIDDK NIH HHS; N01 DK092324/DK/NIDDK NIH HHS; N01 DK092325/DK/NIDDK NIH HHS; N01 DK092326/DK/NIDDK NIH HHS; N01 DK092327/DK/NIDDK NIH HHS; N01 DK092328/DK/NIDDK NIH HHS; N01-DK-9-2318/DK/NIDDK NIH HHS; N01-DK-9-2319/DK/NIDDK NIH HHS; N01-DK-9-2320/DK/NIDDK NIH HHS; N01-DK-9-2321/DK/NIDDK NIH HHS; N01-DK-9-2322/DK/NIDDK NIH HHS; N01-DK-9-2323/DK/NIDDK NIH HHS; N01-DK-9-2324/DK/NIDDK NIH HHS; N01-DK-9-2325/DK/NIDDK NIH HHS; N01-DK-9-2326/DK/NIDDK NIH HHS; N01-DK-9-2327/DK/NIDDK NIH HHS; N01-DK-9-2328/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Angiotensin Receptor Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors
Comments/Corrections

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