Nonselective beta‐blockers are associated with a lower risk of hepatocellular carcinoma among cirrhotic patients in the United States

Wijarnpreecha, Karn; Li, Fang; Xiang, Yang; Xu, Xun; Zhu, Cong; Maroufy, Vahed; Wang, Qing; Tao, Wei; Dang, Yifang; Pham, Huy Anh; Zhou, Yujia; Li, Jianfu; Xu, Hua; Taner, C. Burcin; Yang, Liu; Tao, Cui

doi:10.1111/apt.16490

Cited by 27 publications

(24 citation statements)

References 43 publications

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“…The results of the subgroup analysis revealed that the carvedilol monotherapy group did not have a significantly lower incidence of HCC than did the nonusers, although the adjusted HR for the carvedilol group was lower than that for the propranolol group. A study demonstrated a significantly lower risk of HCC in patients with cirrhosis by using carvedilol, propranolol, and nadolol (Wijarnpreecha et al, 2021). This finding differs from that of this study possibly because of differences in disease severity between the two studies.…”

Section: Discussioncontrasting

confidence: 98%

“…Studies have reported a more significant protective effect on HCC incidence in patients with HCV-or alcohol-related cirrhosis than in those with HBV-related cirrhosis (Kim et al, 2012;Nkontchou et al, 2012;Herrera et al, 2016;Yeh et al, 2019). The results of our study are consistent with those of a stratified analysis of patients with HBV-associated cirrhosis (Wijarnpreecha et al, 2021). Tolerant doses to NSBBs in different ethnic groups may have resulted in no remarkable effect on HCC prevention in this study.…”

Section: Discussionsupporting

confidence: 89%

“…Studies have indicated a significant association between NSBB use and a significantly lower risk of HCC in patients with cirrhosis (Nkontchou et al, 2012;Herrera et al, 2016;Wijarnpreecha et al, 2021). However, patients with cirrhosis who cannot use NSBBs may have more advanced liver diseases and thus a higher risk of HCC.…”

Section: Discussionmentioning

confidence: 99%

“…For patients with cirrhosis and oesophageal varices, NSBBs are recommended for the primary and secondary prevention of variceal bleeding (Tripathi, 2012;Garcia-Tsao et al, 2017). Some clinical studies have reported that NSBBs exert pleiotropic effects such as reducing the risk of HCC in patients with liver cirrhosis (Nkontchou et al, 2012;Thiele et al, 2015;Herrera et al, 2016;Wijarnpreecha et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

“…Clinical studies have reported controversial findings regarding the role of NSBBs in HCC prevention, and most studies have recruited only patients with cirrhosis as the study population (Kim et al, 2012;Hagberg et al, 2016;Yeh et al, 2019;Wijarnpreecha et al, 2021). No study has examined the association between NSBBs and the incidence of HCC in patients with CHB who may develop HCC without cirrhosis and have a lower risk of HCC than do patients with existing cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

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

Cheng

Lin

et al. 2022

Front. Pharmacol.

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Background: Nonselective beta-blockers (NSBBs) can reduce the incidence or mortality of certain types of cancers, and NSBBs exert a protective effect on hepatocellular carcinoma (HCC) in patients with cirrhosis. However, the potential preventive effect of NSBBs has not yet been investigated in patients with chronic hepatitis B (CHB) who have a high HCC risk regardless of the presence of underlying cirrhosis.Aim: This study evaluated the association between NSBB use and HCC incidence in patients with CHB without cirrhosis and decompensation.Methods: From the 2000 Longitudinal Generation Tracking Database, we enrolled patients who were newly diagnosed as having CHB from January 2001 to December 2011 and then followed them up for at least 5 years. To estimate the causal effect of NSBBs on the time-to-event outcomes of HCC, a marginal Cox proportional hazards model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).Results: After adjustment, no significant benefit of HCC risk reduction was observed between the NSBB users and nonusers (adjusted HR, 0.82; 95% CI, 0.52–1.31). The cumulative defined daily dose (cDDD) analysis revealed no significant dose correlation among the three groups [adjusted HR (95% CI): 1.08, (0.56–2.05), 0.54 (0.17–1.77), and 0.76 (0.40–1.42) in the <90 cDDD, 90 to <180 cDDD, and ≥180 cDDD groups, respectively]. Duration-dependent associations were not observed. Multivariable stratified analysis results demonstrated that HCC risk markedly decreased in the patients aged >55 years (adjusted HR, 0.49; 95% CI, 0.25–0.96; p = 0.04).Conclusion: NSBB did not significantly prevent HCC in the patients with CHB infection without cirrhosis and decompensation. This study provided one of valuable results that it is not clinically required to use NSBBs as recommended chemoprevention for HCC in high-risk patients who have CHB.

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Section: Discussioncontrasting

confidence: 98%