Entecavir plus Biejia-Ruangan compound reduces the risk of hepatocellular carcinoma in Chinese patients with chronic hepatitis B

The utility of P-I-R classification in predicting the on-treatment histological and clinical outcomes of patients with hepatitis B and advanced liver fibrosis

“…This extension study of a large prospective multicenter, randomized controlled clinical trial demonstrated that the P-I-R classification could further differentiate not only the on-treatment histological outcomes but also the In this extension study, we also confirmed that longterm ETV with or without BJRG could lead to significant fibrosis regression and reversal of cirrhosis in a substantial proportion of treated patients, as assessed by both Ishak scoring and P-I-R classification, which is in line with other reports on the histological efficacy of antiviral therapy in patients with CHB. [9][10][11][12][13] Furthermore, we found that the reversal of liver fibrosis was identified to be 57% by the Ishak fibrosis score, which was significantly lower than the regression rate of 64% (p = 0.014) by the P-I-R classification. The Ishak fibrosis system, [6] with 6 stages of fibrosis, mainly reflects static liver scarring instead of the tendency of progression or regression of the fibrosis process, and it focuses on the severity of, but not the dynamic changes in, fibrosis.…”

“…Because not all patients receiving antiviral treatment experience liver fibrosis regression, [9][10][11][12][13] hepatic decompensation and HCC can eventually occur in some patients despite antiviral treatment. [13] Overall, the incidence of HCC in posttreatment P-I-R progressive cases was 12.7 times higher (0.2% in the first year to 22.8% in the seventh year) than that in the regressive cases.…”

“…[1] Among the well-reported scoring systems, such as Knodell histological activity index, Batts-Ludwig stage, Scheuer, METAVIR, and Ishak system, [2][3][4][5] the histological activity index modified by Ishak is most widely used in clinical trials to assess histological changes. [6][7][8][9][10][11][12][13] However, the Ishak fibrosis score mainly reflects static liver scarring instead of the tendency of progression or regression of the fibrosis process. [14] Furthermore, treatment-induced subtle changes in fibrosis might not be mirrored by the changes in Ishak fibrosis scores.…”

“…Liver biopsy (LBx) remains the reference standard for the histological assessment of hepatic necroinflammation and fibrosis, despite its limitations, such as invasiveness, sampling error, and interobserver/intraobserver variability 1 . Among the well-reported scoring systems, such as Knodell histological activity index, Batts-Ludwig stage, Scheuer, METAVIR, and Ishak system, 2–5 the histological activity index modified by Ishak is most widely used in clinical trials to assess histological changes 6–13 . However, the Ishak fibrosis score mainly reflects static liver scarring instead of the tendency of progression or regression of the fibrosis process 14 .…”

Curative effect of anti-fibrosis Chinese patent medicines combined with ursodeoxycholic acid for primary biliary cholangitis: A systematic review and meta-analysis

“…Traditional Chinese medicine (TCM) has advantages in treating liver fibrosis, owing to its combination of ingredients and multiple pathways and targets. Previous studies have shown that Fuzheng Huayu capsules (FZHY) ( Liu et al, 2019 ), Fufang Biejia Ruangan tablets (FFBJRG) ( Ji et al, 2022 ), and Anluo Huaxian pills (ALHX) ( Lu et al, 2017 ) are commonly used clinically as Chinese patent medicines (CPMs) for the anti-fibrosis treatment of liver these have been approved by the State Food and Drug Administration of China, with national medicine permission numbers of Z20020074 (FZHY), Z19991011 (FFBJRG), and Z20010098 (ALHX). The fibrosis stage is important in the progression of PBC.…”