Non-selective beta-blockers and the incidence of hepatocellular carcinoma in patients with cirrhosis: a meta-analysis
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 ce...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2023.1216059/full |
| _version_ | 1797777372054814720 |
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| author | Xinyi He Xinyi He Zimo Zhao Zimo Zhao Xi Jiang Yan Sun |
| author_facet | Xinyi He Xinyi He Zimo Zhao Zimo Zhao Xi Jiang Yan Sun |
| author_sort | Xinyi He |
| collection | DOAJ |
| description | 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.Methods: We searched the Cochrane database, MEDLINE, EMBASE, PubMed, and Web of Science. Cohort studies, case‒control studies, and randomized controlled trials were included if they involved cirrhosis patients who were divided into an experimental group using NSBBs and a control group with any intervention. Based on heterogeneity, we calculated odds ratio (OR) and 95% confidence interval (CI) using random-effect models. We also conducted subgroup analysis to explore the source of heterogeneity. Sensitivity analysis and publication bias detection were performed.Results: A total of 47 studies included 38 reporting HCC incidence, 26 reporting HCC-related mortality, and 39 reporting overall mortality. The HCC incidence between the experimental group and the control group was OR = 0.87 (0.69 and 1.10), p = 0.000, and I2 = 81.8%. There was no significant association between propranolol (OR = 0.94 and 95%CI 0.62–1.44) or timolol (OR = 1.32 and 95%CI 0.44–3.95) and HCC incidence, while the risk of HCC decreased by 26% and 38% with nadolol (OR = 0.74 and 95%CI 0.64–0.86) and carvedilol (OR = 0.62 and 95%CI 0.52–0.74), respectively.Conclusion: Different types of NSBB have different effects on the incidence of patients with cirrhosis of the liver, where nadolol and carvedilol can reduce the risk. Also, the effect of NSBBs may vary in ethnicity. Propranolol can reduce HCC incidence in Europe and America.Systematic Review Registration: identifier https://CRD42023434175, https://www.crd.york.ac.uk/PROSPERO/. |
| first_indexed | 2024-03-12T23:03:06Z |
| format | Article |
| id | doaj.art-bf58a4ced7774f1fa19cf70ac0922369 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-03-12T23:03:06Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-bf58a4ced7774f1fa19cf70ac09223692023-07-19T07:45:09ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122023-07-011410.3389/fphar.2023.12160591216059Non-selective beta-blockers and the incidence of hepatocellular carcinoma in patients with cirrhosis: a meta-analysisXinyi He0Xinyi He1Zimo Zhao2Zimo Zhao3Xi Jiang4Yan Sun5Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, ChinaClinical Department I, China Medical University, Shenyang, Liaoning, ChinaDepartment of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, ChinaFirst Clinical Medical College, China Medical University, Shenyang, Liaoning, ChinaDepartment of Cardiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, ChinaDepartment of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, ChinaBackground: 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.Methods: We searched the Cochrane database, MEDLINE, EMBASE, PubMed, and Web of Science. Cohort studies, case‒control studies, and randomized controlled trials were included if they involved cirrhosis patients who were divided into an experimental group using NSBBs and a control group with any intervention. Based on heterogeneity, we calculated odds ratio (OR) and 95% confidence interval (CI) using random-effect models. We also conducted subgroup analysis to explore the source of heterogeneity. Sensitivity analysis and publication bias detection were performed.Results: A total of 47 studies included 38 reporting HCC incidence, 26 reporting HCC-related mortality, and 39 reporting overall mortality. The HCC incidence between the experimental group and the control group was OR = 0.87 (0.69 and 1.10), p = 0.000, and I2 = 81.8%. There was no significant association between propranolol (OR = 0.94 and 95%CI 0.62–1.44) or timolol (OR = 1.32 and 95%CI 0.44–3.95) and HCC incidence, while the risk of HCC decreased by 26% and 38% with nadolol (OR = 0.74 and 95%CI 0.64–0.86) and carvedilol (OR = 0.62 and 95%CI 0.52–0.74), respectively.Conclusion: Different types of NSBB have different effects on the incidence of patients with cirrhosis of the liver, where nadolol and carvedilol can reduce the risk. Also, the effect of NSBBs may vary in ethnicity. Propranolol can reduce HCC incidence in Europe and America.Systematic Review Registration: identifier https://CRD42023434175, https://www.crd.york.ac.uk/PROSPERO/.https://www.frontiersin.org/articles/10.3389/fphar.2023.1216059/fulladrenergic beta-antagonistsliver cancerhepatocellular carcinomaliver cirrhosisportal hypertensionmeta-analysis |
| spellingShingle | Xinyi He Xinyi He Zimo Zhao Zimo Zhao Xi Jiang Yan Sun Non-selective beta-blockers and the incidence of hepatocellular carcinoma in patients with cirrhosis: a meta-analysis Frontiers in Pharmacology adrenergic beta-antagonists liver cancer hepatocellular carcinoma liver cirrhosis portal hypertension meta-analysis |
| title | Non-selective beta-blockers and the incidence of hepatocellular carcinoma in patients with cirrhosis: a meta-analysis |
| title_full | Non-selective beta-blockers and the incidence of hepatocellular carcinoma in patients with cirrhosis: a meta-analysis |
| title_fullStr | Non-selective beta-blockers and the incidence of hepatocellular carcinoma in patients with cirrhosis: a meta-analysis |
| title_full_unstemmed | Non-selective beta-blockers and the incidence of hepatocellular carcinoma in patients with cirrhosis: a meta-analysis |
| title_short | Non-selective beta-blockers and the incidence of hepatocellular carcinoma in patients with cirrhosis: a meta-analysis |
| title_sort | non selective beta blockers and the incidence of hepatocellular carcinoma in patients with cirrhosis a meta analysis |
| topic | adrenergic beta-antagonists liver cancer hepatocellular carcinoma liver cirrhosis portal hypertension meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2023.1216059/full |
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