Is there any vindication for low dose nonselective β-blocker medication in patients with liver cirrhosis?
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Background/Aims: Nonselective β-blockers (NSBBs), such as propranolol, reportedly exert a pleiotropic eff ect in liver cirrhosis. A previous report suggested that survival was higher in patients receiving adjusted doses of NSBBs than in ligation patients. This study investigated whether low-dose NSBB medication has benefi cial eff ects in patients with liver cirrhosis, especially in terms of overall survival. Methods: We retrospectively studied 273 cirrhotic patients (199 males; age 53.6±10.2 years, mean±SD) who visited our institution between March 2003 and December 2007; follow-up data were collected until June 2011. Among them, 138patients were given a low-dose NSBB (BB group: propranolol, 20-60 mg/day), and the remaining 135 patients were not given an NSBB (NBB group). Both groups were stratifi ed randomly according to Child-Turcotte-Pugh (CTP) classifi cation and age. Results: The causes of liver cirrhosis were alcohol (n=109, 39.9%), hepatitis B virus (n=125, 45.8%), hepatitis C virus (n=20,7.3%), and cryptogenic (n=19, 7.0%). The CTP classes were distributed as follows: A, n=116, 42.5%; B, n=126, 46.2%; and C,n=31, 11.4%. Neither the overall survival (P=0.133) nor the hepatocellular carcinoma (HCC)-free survival (P =0.910) diff ered signifi cantly between the BB and NBB groups [probability of overall survival at 4 years: 75.1% (95% CI=67.7-82.5%) and 81.2% (95% CI=74.4–88.0%), respectively; P=0.236]. In addition, the delta CTP score did not diff er signifi cantly between the two groups. Conclusions: Use of low-dose NSBB medication in patients with liver cirrhosis is not indicated in terms of overall and HCC-free survival. (Clin Mol Hepatol 2012;18:203-212)
Abstract
Background/Aims: Nonselective β-blockers (NSBBs), such as propranolol, reportedly exert a pleiotropic eff ect in liver cirrhosis. A previous report suggested that survival was higher in patients receiving adjusted doses of NSBBs than in ligation patients. This study investigated whether low-dose NSBB medication has benefi cial eff ects in patients with liver cirrhosis, especially in terms of overall survival. Methods: We retrospectively studied 273 cirrhotic patients (199 males; age 53.6±10.2 years, mean±SD) who visited our institution between March 2003 and December 2007; follow-up data were collected until June 2011. Among them, 138patients were given a low-dose NSBB (BB group: propranolol, 20-60 mg/day), and the remaining 135 patients were not given an NSBB (NBB group). Both groups were stratifi ed randomly according to Child-Turcotte-Pugh (CTP) classifi cation and age. Results: The causes of liver cirrhosis were alcohol (n=109, 39.9%), hepatitis B virus (n=125, 45.8%), hepatitis C virus (n=20,7.3%), and cryptogenic (n=19, 7.0%). The CTP classes were distributed as follows: A, n=116, 42.5%; B, n=126, 46.2%; and C,n=31, 11.4%. Neither the overall survival (P=0.133) nor the hepatocellular carcinoma (HCC)-free survival (P =0.910) diff ered signifi cantly between the BB and NBB groups [probability of overall survival at 4 years: 75.1% (95% CI=67.7-82.5%) and 81.2% (95% CI=74.4–88.0%), respectively; P=0.236]. In addition, the delta CTP score did not diff er signifi cantly between the two groups. Conclusions: Use of low-dose NSBB medication in patients with liver cirrhosis is not indicated in terms of overall and HCC-free survival. (Clin Mol Hepatol 2012;18:203-212)
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