Abstract:
BACKGROUND & AIMS:Non-selective beta blockers (NSBBs) have been shown to have deleterious outcomes in patients with refractory ascites, alcoholic hepatitis and spontaneous bacterial peritonitis leading many physicians to stop the drug in these cases. Acute-on-chronic liver failure (ACLF) is characterized by systemic inflammation and high mortality. As NSBBs may have beneficial effects on gut motility and permeability and, systemic inflammation, the aims of this prospective, observational study were to determine whether ongoing use of NSBBs reduced 28-day mortality in ACLF patients. METHODS:The study was performed in 349 patients with ACLF included in the CANONIC study, which is a prospective observational investigation in hospitalized cirrhotic patients with acute deterioration. The data about the use of NSBBs, its type and dosage was specifically recorded. Patient characteristics at enrollment significantly associated with treatment and mortality were taken into account as potential confounders to adjust for treatment effect. A logistic regression model was fitted. RESULTS:164 (47%) ACLF patients received NSBBs whereas 185 patients did not. Although the CLIF-C ACLF scores were similar at presentation, more patients in the NSBB treated group had lower grades of ACLF (p=0.047) at presentation and significantly more patients improved. Forty patients (24.4%) died in NSBB treated group compared with 63 patients (34.1%) (p=0.048) [estimated risk-reduction 0.596 (95%CI: 0.361-0.985; p=0.0436)]. This improvement in survival was associated with a significantly lower white cell count (NSBB: 8.5 (5.8); no NSBB: 10.8 (6.6); p=0.002). No long-term improvement in survival was observed. CONCLUSIONS:This study shows for the first time that ongoing treatment with NSBBs in cirrhosis is safe and reduces the mortality if they develop ACLF. Careful thought should be given before stopping NSBBs in cirrhotic patients.
journal_name
J Hepatoljournal_title
Journal of hepatologyauthors
Mookerjee RP,Pavesi M,Thomsen KL,Mehta G,Macnaughtan J,Bendtsen F,Coenraad M,Sperl J,Gines P,Moreau R,Arroyo V,Jalan R,CANONIC Study Investigators of the EASL-CLIF Consortium.doi
10.1016/j.jhep.2015.10.018subject
Has Abstractpub_date
2016-03-01 00:00:00pages
574-82issue
3eissn
0168-8278issn
1600-0641pii
S0168-8278(15)00717-5journal_volume
64pub_type
杂志文章abstract:BACKGROUND/AIMS:Although 6-thioguanine (6-TG) has been suggested as an effective treatment option for patients with inflammatory bowel disease (IBD), the recent description of its hepatotoxicity has led to the recommendation not to consider this drug. We initiated a multicenter safety study in IBD-patients treated with...
journal_title:Journal of hepatology
pub_type: 杂志文章,多中心研究
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abstract:BACKGROUND/AIMS:The aim of this study was to identify human liver proteins that are associated with different stages of liver development. METHODS:We collected liver samples from 14 fetuses between 14 and 41 weeks of development, one child and four adults. Proteins which exhibited consistent and significant variations...
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abstract:BACKGROUND/AIMS:The aim of this study is to verify the efficacy and safety of peg-interferon alfa-2b in combination with ribavirin for initial treatment of HCV-associated mixed cryoglobulinemia. METHODS:Eighteen patients (7 women and 11 men) affected by mixed cryoglobulinemia were included in the study and treated wit...
journal_title:Journal of hepatology
pub_type: 临床试验,杂志文章
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abstract:BACKGROUND & AIMS:Modulation of dendritic cell (DC) function has been theorized as one of the mechanisms used by hepatitis C virus (HCV) to evade the host immune response and cause persistent infection. METHODS:We used a range of cell and molecular biology techniques to study DC subsets from uninfected and HCV-infecte...
journal_title:Journal of hepatology
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abstract:BACKGROUND/AIMS:To study whether the host's immune response determines viral clearance in chronic hepatitis C, virological markers and antigen-specific T cell reactions were analysed in 30 chronic HCV carriers followed up during interferon-alpha therapy, 11 untreated anti-HCV positive individuals and 10 healthy control...
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更新日期:1998-10-01 00:00:00
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journal_title:Journal of hepatology
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abstract:BACKGROUND/AIMS:Currently the diagnosis and severity of hepatic steatosis can be established accurately only by liver biopsy. Previous small studies found that steatosis measured by magnetic resonance spectroscopy (MRS) and imaging (MRI) correlated with histological assessment of liver triglyceride content. However, th...
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更新日期:2009-08-01 00:00:00
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更新日期:1988-12-01 00:00:00
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更新日期:2017-04-01 00:00:00
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journal_title:Journal of hepatology
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更新日期:2003-04-01 00:00:00
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journal_title:Journal of hepatology
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更新日期:2006-11-01 00:00:00
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journal_title:Journal of hepatology
pub_type: 杂志文章
doi:10.1016/j.jhep.2006.09.020
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND & AIMS:The approval of all-oral direct-acting antiviral (DAA) regimens for the treatment of hepatitis C virus (HCV) has led to the expansion of therapy to include patients with cirrhosis who have hepatocellular carcinoma (HCC). Data on the use of DAAs in HCV+ patients with HCC is limited. The aim of this stu...
journal_title:Journal of hepatology
pub_type: 杂志文章
doi:10.1016/j.jhep.2017.01.020
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND/AIMS:The pathogenic relevance of the hepatitis G virus (HGV) and its sensitivity to interferon are currently under investigation. This study aimed to investigate the prevalence of HGV infection in patients with chronic hepatitis C and to elucidate if HGV co-infection modifies the clinical course and the resp...
journal_title:Journal of hepatology
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doi:10.1016/s0168-8278(97)80243-7
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journal_title:Journal of hepatology
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pub_type: 临床试验,杂志文章
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abstract:BACKGROUND & AIMS:IL28B polymorphisms, jaundice, decline in HCV-RNA, IP-10, and gender have been proposed to be indicative of spontaneous clearance of acute hepatitis C virus infection. The aim of this study was to define a score enabling the discrimination of patients with spontaneous clearance of HCV from those with ...
journal_title:Journal of hepatology
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journal_title:Journal of hepatology
pub_type: 杂志文章
doi:10.1016/s0168-8278(96)80200-5
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journal_title:Journal of hepatology
pub_type: 杂志文章
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更新日期:2020-07-01 00:00:00
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journal_title:Journal of hepatology
pub_type: 杂志文章
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journal_title:Journal of hepatology
pub_type: 杂志文章
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journal_title:Journal of hepatology
pub_type: 杂志文章
doi:10.1016/s0168-8278(00)00108-2
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND/AIMS:Suppressor of cytokine signaling (SOCS)-1, a negative feedback regulator of cytokine signaling pathway, also has a tumor suppressor activity, the silencing of its gene by hypermethylation is suggested to contribute to hepatocarcinogenesis. We studied the effect of the core protein of hepatitis C virus (...
journal_title:Journal of hepatology
pub_type: 杂志文章
doi:10.1016/j.jhep.2005.03.028
更新日期:2005-11-01 00:00:00
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journal_title:Journal of hepatology
pub_type: 杂志文章
doi:10.1016/j.jhep.2006.05.018
更新日期:2006-11-01 00:00:00