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JOURNAL ARTICLE
Vishal C Patel, Mark J McPhail, Ruhama Uddin, Hassan Jafari, Vanessa Lawrence, Clair Le Boutillier, James Shearer, Nahel Yaziji, Angela Cape, Haroon Ahmed, Christopher Ward, Peter Walsh, Kevin Besly, Ane Zamalloa, Joanna Kelly, Ben Carter
BACKGROUND: Liver disease is within the top five causes of premature death in adults. Deaths caused by complications of cirrhosis continue to rise, whilst deaths related to other non-liver disease areas are declining. Portal hypertension is the primary sequelae of cirrhosis and is associated with the development of variceal haemorrhage, ascites, hepatic encephalopathy and infection, collectively termed hepatic decompensation, which leads to hospitalisation and mortality. It remains uncertain whether administering a non-selective beta-blocker (NSBB), specifically carvedilol, at an earlier stage, i...
April 16, 2024: Trials
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JOURNAL ARTICLE
Philippe Sultanik, Claudia Campani, Edouard Larrey, Bertille Campion, Manon Evain, Charles Roux, Lorraine Blaise, Mathilde Wagner, Marika Rudler, Jean Charles Nault, Dominique Thabut, Manon Allaire
BACKGROUND: Portal hypertension (PHT) often complicates hepatocellular carcinoma (HCC) treatment and prognosis. We aimed to assess PHT's impact on AtezoBev outcomes and identify predictors of acute variceal bleeding (AVB) and clinical ascites occurrence. METHODS: A prospective cohort of 200 HCC patients treated with AtezoBev was studied alongside a retrospective cohort of 123 patients treated with Sorafenib. We assessed factors influencing progression-free survival (PFS), overall survival (OS), AVB and clinical ascites development, focusing on PHT parameters, and comparing outcomes within and between the two cohorts (time-dependent Cox model and adjusted survival curves)...
March 27, 2024: Digestive and Liver Disease
#3
JOURNAL ARTICLE
Hye-Won Jeong, Jae Hwan Kim, Sang-Bin Han, Hye-Mee Kwon, In-Gu Jun, Jun-Gol Song, Gyu-Sam Hwang
INTRODUCTION AND OBJECTIVES: Acute kidney injury (AKI) is prevalent and has deleterious effects on postoperative outcomes following liver transplantation (LT). The impact of nonselective beta-blockers (NSBBs) in patients with liver cirrhosis remains controversial. This study investigated the association between preoperative NSBB use and AKI after living donor LT (LDLT). PATIENTS AND METHODS: We evaluated 2,972 adult LDLT recipients between January 2012 and July 2022...
February 6, 2024: Annals of Hepatology
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JOURNAL ARTICLE
Mohammad Alsaeid, Shuen Sung, Wayne Bai, Matthew Tam, Yu Jun Wong, Jordi Cortes, Erik Cobo, Jose Antonio Gonzalez, Juan G Abraldes
BACKGROUND: It has been suggested that a relevant proportion of patients do not respond to nonselective beta-blockers (NSBB)s, which raises questions regarding the need for individualized therapy. The existence of potential heterogeneity in the treatment response can be assessed using the variability ratio (VR) of the outcome measurement (in this case, HVPG) between the treated and placebo groups. We conducted a systematic review and meta-analysis of randomized controlled trials to assess the potential heterogeneity in the portal pressure response to NSBBs...
February 1, 2024: Hepatology Communications
#5
JOURNAL ARTICLE
Yongshuai Liu, Huijun Chang, Yunqing Zeng, Jinhou Li, Yueyue Li, Yong Chen, Tao Zhou, Yanjing Gao
BACKGROUND: The relation of adipose tissue depletion with prognostic outcome of variceal bleeding among cirrhotic patients is still inconclusive. The present work explored whether adipose tissue, which was measured based on computed tomography (CT), was valuable for analyzing rebleeding and mortality among patients with variceal bleeding who had undergone endoscopic therapy. METHODS: The study encompassed cirrhotic patients who underwent endoscopic therapy to prevent variceal rebleeding between January 2016 and October 2022...
January 8, 2024: Lipids in Health and Disease
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REVIEW
Càndid Villanueva, Victor Sapena, Gin-Ho Lo, Yeon Seok Seo, Hasnain Ali Shah, Virendra Singh, Dhiraj Tripathi, Michael Schepke, Cristian Gheorghe, Daniell Q Bonilha, Rome Jutabha, Huay-Min Wang, Susana G Rodrigues, Anna Brujats, Han Ah Lee, Zahid Azam, Pramod Kumar, Peter C Hayes, Tilman Sauerbruch, Wen-Chi Chen, Speranta Iacob, Ermelindo D Libera, Dennis M Jensen, Edilmar Alvarado, Ferran Torres, Jaume Bosch
BACKGROUND & AIMS: Non-selective β-blockers (NSBBs) and endoscopic variceal-ligation (EVL) have similar efficacy preventing first variceal bleeding. Compensated and decompensated cirrhosis are markedly different stages, which may impact treatment outcomes. We aimed to assess the efficacy of NSBBs vs EVL on survival in patients with high-risk varices without previous bleeding, stratifying risk according to compensated/decompensated stage of cirrhosis. METHODS: By systematic review, we identified RCTs comparing NSBBs vs EVL, in monotherapy or combined, for primary bleeding prevention...
February 2024: Alimentary Pharmacology & Therapeutics
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JOURNAL ARTICLE
Lorenz Balcar, Mattias Mandorfer, Virginia Hernández-Gea, Bogdan Procopet, Elias Laurin Meyer, Álvaro Giráldez, Lucio Amitrano, Candid Villanueva, Dominique Thabut, Luis Ibáñez Samaniego, Gilberto Silva-Junior, Javier Martinez, Joan Genescà, Christophe Bureau, Jonel Trebicka, Elba Llop Herrera, Wim Laleman, José María Palazón Azorín, Jose Castellote Alonso, Lise Lotte Gluud, Carlos Noronha Ferreira, Nuria Cañete, Manuel Rodríguez, Arnulf Ferlitsch, Jose Luis Mundi, Henning Grønbæk, Manuel Nicolas Hernandez Guerra, Romano Sassatelli, Alessandra Dell'Era, Marco Senzolo, Juan Gonzalez Abraldes, Manuel Romero-Gómez, Alexander Zipprich, Meritxell Casas, Helena Masnou, Massimo Primignani, Aleksander Krag, Frederik Nevens, Jose Luis Calleja, Christian Jansen, María Vega Catalina, Agustín Albillos, Marika Rudler, Edilmar Alvarado Tapias, Maria Anna Guardascione, Marcel Tantau, Rémy Schwarzer, Thomas Reiberger, Stig Borbjerg Laursen, Marta Lopez-Gomez, Alba Cachero, Alberto Ferrarese, Cristina Ripoll, Vincenzo La Mura, Jaime Bosch, Juan Carlos García-Pagán
BACKGROUND & AIMS: Pre-emptive transjugular intrahepatic portosystemic shunt (TIPS) is the treatment of choice for high-risk acute variceal bleeding (AVB; i.e., Child-Turcotte-Pugh [CTP] B8-9+active bleeding/C10-13). Nevertheless, some 'non-high-risk' patients have poor outcomes despite the combination of non-selective beta-blockers and endoscopic variceal ligation for secondary prophylaxis. We investigated prognostic factors for re-bleeding and mortality in 'non-high-risk' AVB to identify subgroups who may benefit from more potent treatments (i...
January 2024: Journal of Hepatology
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JOURNAL ARTICLE
Mason Lai, Cynthia Fenton, Jin Ge, Jessica Rubin, Jennifer C Lai, Giuseppe Cullaro
BACKGROUND AND AIMS: Nonselective beta-blockers (NSBB) protect patients with compensated cirrhosis; however, it is unclear if NSBB is associated with acute kidney injury (AKI) in patients with decompensated cirrhosis. We aimed to determine if the use of NSBB was associated with an increased risk of stage II AKI or greater and waitlist mortality (WLM) among patients with decompensated cirrhosis awaiting liver transplant stratified by cirrhosis severity. METHODS: Included were 1816 outpatients listed for liver transplantation at UCSF from June 2012 to April 2022...
October 1, 2023: Hepatology Communications
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JOURNAL ARTICLE
Ka-Shing Cheung, Chiu-Hang Mok, Lok-Ka Lam, Xian-Hua Mao, Lung-Yi Mak, Wai-Kay Seto, Man-Fung Yuen
BACKGROUND AND AIMS: We aimed to perform a network meta-analysis (NWM) to examine comparative effectiveness of non-selective beta blockers (NSBBs) on prophylaxis of gastroesophageal variceal bleeding (GVB) and mortality benefit. METHODS: MEDLINE (OVID) and EMBASE databases were searched for eligible randomized clinical trials (RCTs) from inception to July 3, 2021. Outcomes of interest included primary/secondary prophylaxis of GVB, failure to achieve hepatic venous pressure gradient (HVPG) decremental response, liver-related and all-cause mortality...
October 28, 2023: Journal of Clinical and Translational Hepatology
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Xinyi He, Zimo Zhao, Xi Jiang, Yan Sun
Background: Hepatocellular carcinoma (HCC) is a serious complication of cirrhosis. Currently, non-selective beta-blockers (NSBBs) are commonly used to treat portal hypertension in patients with cirrhosis. The latest research shows that NSBBs can induce apoptosis and S-phase arrest in liver cancer cells and inhibit the development of hepatic vascular endothelial cells, which may be effective in preventing HCC in cirrhosis patients. Aim: To determine the relationship between different NSBBs and HCC incidence in patients with cirrhosis...
2023: Frontiers in Pharmacology
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JOURNAL ARTICLE
Rafael Paternostro, Mathias Jachs, Lukas Hartl, Benedikt Simbrunner, Bernhard Scheiner, David Bauer, Philipp Schwabl, Georg Semmler, Michael Trauner, Mattias Mandorfer, Thomas Reiberger
BACKGROUND: Non-selective betablockers (NSBBs) reduce the risk of hepatic decompensation in patients with compensated advanced chronic liver disease (cACLD). Metabolic co-morbidities (MetC) are increasingly observed in cACLD patients. AIMS: To investigate the impact of MetC on the haemodynamic effects of NSBB and hepatic decompensation in cACLD. METHODS: cACLD patients undergoing paired hepatic venous pressure gradient (HVPG) measurements before/under NSBB therapy were retrospectively considered for this study...
October 2023: Alimentary Pharmacology & Therapeutics
#12
JOURNAL ARTICLE
Xi-Xuan Wang, Xiao-Chun Yin, Li-Hong Gu, Hui-Wen Guo, Yang Cheng, Yan Liu, Jiang-Qiang Xiao, Yi Wang, Wei Zhang, Xiao-Ping Zou, Lei Wang, Ming Zhang, Yu-Zheng Zhu-Ge, Feng Zhang
BACKGROUND: It is controversial whether transjugular intrahepatic portosystemic shunt (TIPS) placement can improve long-term survival. AIM: To assess whether TIPS placement improves survival in patients with hepatic-venous-pressure-gradient (HVPG) ≥ 16 mmHg, based on HVPG-related risk stratification. METHODS: Consecutive variceal bleeding patients treated with endoscopic therapy + nonselective β-blockers (NSBBs) or covered TIPS placement were retrospectively enrolled between January 2013 and December 2019...
June 14, 2023: World Journal of Gastroenterology: WJG
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JOURNAL ARTICLE
Karen Vagner Danielsen, Puria Nabilou, Signe Skovgaard Wiese, Jens Dahlgaard Hove, Flemming Bendtsen, Søren Møller
BACKGROUND: Non-selective beta-blockers (NSBB) are widely used in the treatment of patients with cirrhosis. Only about 50% respond with a sufficient reduction in their hepatic venous pressure gradient (HVPG) and NSBB may induce detrimental cardiac and renal effects in the presence of severe decompensation. We aimed to assess the effects of NSBB on haemodynamics using magnetic resonance imaging (MRI) and to assess if these haemodynamic changes were related to the disease severity and HVPG response...
June 30, 2023: Liver International: Official Journal of the International Association for the Study of the Liver
#14
JOURNAL ARTICLE
Morten Daniel Jensen, Hugh Watson, Hendrik Vilstrup, Peter Jepsen
BACKGROUND AND AIMS: Previous studies have not been able to determine whether non-selective beta-blockers (NSBB) reduce the risk of sepsis in cirrhosis. We aimed to examine this question with data from 1198 patients with cirrhosis and ascites included in clinical studies of satavaptan, a vasopressin receptor antagonist with no effect on infection risk. METHODS: Risk of sepsis was estimated for NSBB users vs nonusers. Patients were examined every four weeks, or in relation to hospitalization, for the one-year duration of the trials...
2023: Clinical Epidemiology
#15
JOURNAL ARTICLE
Antoine Le Bozec, Mathias Brugel, Zoubir Djerada, Marya Ayad, Marine Perrier, Claire Carlier, Damien Botsen, Pierre Nazeyrollas, Olivier Bouché, Florian Slimano
Introduction: Preclinical studies have demonstrated the possible role of beta-adrenergic receptors in pancreatic ductal adenocarcinoma (PDAC) tumor invasion and migration. The current study aimed to explore the possible association between survival outcomes and beta-blocker (BB) exposure in patients with advanced PDAC. Methods: This retrospective single-center study included 182 patients with advanced PDAC. Clinical [age, sex, BMI, cardiovascular condition, presence (SBB) or absence (NSBB) of beta-1 selectivity of BB, exposure duration, and multimorbidity], oncological (stage and anticancer treatment regimen), and biological (renal and liver function) data were collected...
2023: Frontiers in Pharmacology
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JOURNAL ARTICLE
Susana Almenara, Beatriz Lozano-Ruiz, Ivan Herrera, Paula Gimenez, Cayetano Miralles, Pablo Bellot, Maria Rodriguez, Jose M Palazon, Fabián Tarín, Héctor Sarmiento, Rubén Francés, Jose Manuel Gonzalez-Navajas, Sonia Pascual, Pedro Zapater
BACKGROUND: Treatment with non-selective beta-blockers (NSBB) has been associated with anti-inflammatory and anti-cancer effects in patients with cirrhosis. This study aims to analyze the impact of chronic NSBB treatment on immune activation and disease progression in stable outpatients with cirrhosis. METHODS: In this prospective follow-up of 150 patients with cirrhosis, 39 received treatment with NSBB. Blood samples were taken every 6-9 months, and immune and adrenergic variables were measured...
July 2023: Biomedicine & Pharmacotherapy
#17
JOURNAL ARTICLE
E H Dai, X R Guo, J T Wang, Q G Hu, J H Li, Q Y Tang, H M Zu, H Huan, Y Wang, Y F Gao, G Q Hu, W Li, Z J Liu, Q P Ma, Y L Song, J H Yang, Y Zhu, S D Huang, Z J Meng, B Bai, Y P Chen, C Gao, M X Huang, S Q Jin, M Z Lu, Z Xu, Q H Zhang, S Zheng, Q L Zeng, X L Qi
Objective: To investigate the etiology, prevention and treatment status, and their corresponding regional differences of the patients with liver cirrhosis in China, in order to provide scientific basis for the development of diagnosis and control strategies in China. Methods: Clinical data of patients diagnosed with liver cirrhosis for the first time through January 1, 2018 to December 31, 2020 from 50 hospitals in seven different regions of China were collected and analyzed retrospectively, and the difference of etiology, treatment, and their differences in various regions were analyzed...
March 28, 2023: Zhonghua Yi Xue za Zhi [Chinese medical journal]
#18
JOURNAL ARTICLE
Randeep Rana, Sanchit Sharma, Syed Ahmed, Anany Gupta, Wong Y Jun, Deepak Gunjan, Anoop Saraya
Non-selective beta-blockers (NSBBs) have a role in the management of portal hypertension. They are currently advocated in patients with clinically significant portal hypertension (CSPH) based on Baveno-VII consensus. Current survey aimed to evaluate the practice and perceptions of prescribing NSBBs in portal hypertension by gastroenterologists and hepatologists in Asia-Pacific region in patients with compensated cirrhosis. Out of 1500 gastroenterologists approached in the region, 328 gastroenterologists responded and completed the survey...
2023: Journal of Clinical and Experimental Hepatology
#19
REVIEW
Laura Turco, Thomas Reiberger, Giovanni Vitale, Vincenzo La Mura
Portal hypertension (PH) is the most common complication ofcirrhosis and represents the main driver of hepatic decompensation. The overarching goal of PH treatments in patients with compensated cirrhosis is to reduce the risk of hepatic decompensation (i.e development of ascites, variceal bleeding and/or hepatic encephalopathy). In decompensated patients, PH-directed therapies aim at avoiding further decompensation (i.e. recurrent/refractory ascites, variceal rebleeding, recurrent encephalopathy, spontaneous bacterial peritonitis or hepatorenal syndrome) and at improving survival...
June 2023: Liver International: Official Journal of the International Association for the Study of the Liver
#20
JOURNAL ARTICLE
X Su, W J Li, Z Chen, Q B Wu, M H Yin, X Han, D P Zhang, X Q Zhou, H Zhu
Objective: To explore whether NSBB is suitable for the primary prevention of liver cirrhosis accompanied by CSPH with no or small esophageal varices. Methods: Relevant literatures were retrieved from Cochrane library, PubMed, EMBASE, SinoMed, CNKI and Wanfang databases until December 12, 2020. All randomized controlled trials (RCTs) on NSBB use for primary prevention of cirrhosis accompanied by CSPH with no or small esophageal varices were collected. The literature was strictly screened according to the established inclusion and exclusion criteria, odds ratio (OR), and 95% confidence interval (CI) combined effect size...
November 20, 2022: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
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