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Daily Aspirin Use Associated With Reduced Risk For Fibrosis Progression In Patients With Nonalcoholic Fatty Liver Disease
Open accessAbstract
Background & aims There are few data from prospective studies on the effects of aspirin on fibrosis in patients with nonalcoholic fatty liver disease (NAFLD).Methods We performed a prospective cohort study of 361 adults with biopsy-confirmed NAFLD, from 2006 through 2015, examined every 3-12 months for incident advanced fibrosis defined using serial measurements of validated indices (the Fibrosis-4, NAFLD fibrosis score, and aspartate aminotransferase to platelet ratio indices). Histologic analyses of liver biopsies collected at baseline were performed by a blinded pathologist. Information collected at baseline and at each examination included frequency and duration of aspirin and nonsteroidal anti-inflammatory drug (NSAID) use. Using multivariable-adjusted logistic regression, we estimated the association of aspirin use with prevalent steatohepatitis (NASH) and fibrosis. Using multivariable-adjusted Cox proportional hazards modeling, we estimated the association between aspirin use and risk for fibrosis progression.Results At enrollment, 151 subjects used aspirin daily. Compared with non-regular use, daily aspirin use was associated with significantly lower odds of NASH (adjusted odds ratio, 0.68; 95% CI, 0.37-0.89) and fibrosis (adjusted odds ratio, 0.54; 95% CI, 0.31-0.82). Among individuals with baseline F0-F2 fibrosis (n = 317), 86 developed advanced fibrosis over 3692 person-years. Daily aspirin users had significantly lower risk for developing incident advanced fibrosis vs non-regular users (adjusted hazard ratio [aHR], 0.63; 95% CI, 0.43-0.85). This relationship appeared to be duration dependent (adjusted P trend=.026), with the greatest benefit found with at least 4 years or more of aspirin use (aHR, 0.50; 95% CI, 0.35-0.73). Conversely, use of nonaspirin NSAIDs was not associated with risk for advanced fibrosis (aHR, 0.93; 95% CI, 0.81-1.05).Conclusions In a prospective study of patients with biopsy-proven NAFLD, daily aspirin use was associated with less severe histologic features of NAFLD and NASH, and lower risk for progression to advanced fibrosis with time.
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“Treatment of cardiometabolic comorbidities may modify disease progression and contribute to a reduction in liverrelated events ( e.g. statins, aspirin, renin-angiotensinaldosterone modulators). 273,274”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [274]
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Tacke, F., Horn, P., Wai-Sun Wong, V., Ratziu, V., Bugianesi, E., Francque, S., Zelber-Sagi, S., Valenti, L., Roden, M., Schick, F., et al. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.04.031 · Cited by 2,210
NAFLD and cardiovascular diseases: a clinical review
Kasper, P., Martin, A., Lang, S., Kütting, F., Goeser, T., Demir, M., & Steffen, H. (2020) · Clinical Research in Cardiology · doi:10.1007/s00392-020-01709-7 · Cited by 691
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NAFLD-driven HCC: Safety and efficacy of current and emerging treatment options
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Association Between Psoriasis and Nonalcoholic Fatty Liver Disease Among Outpatient US Adults
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Metadata
- Authors
- Simon, T. G., Henson, J., Osganian, S., Masia, R., Chan, A. T., Chung, R. T., & Corey, K. E.
- Affiliations
- Harvard University (US)
- Brigham and Women's Hospital (US)
- Massachusetts General Hospital (US)
- Broad Institute (US)
- Corresponding author
- Corey, Kathleen E.
- ORCID
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2019-12
- Volume
- 17
- Issue
- 13
- Pages
- 2776-2784.e4
- ISSN
- 1542-3565 (ISSN-L)
- PMC
- PMC6842070
- OpenAlex
- W2944339954
- Cited by
- 180
- References
- 36
- Citations by year
- 2026: 10 · 2025: 28 · 2024: 30 · 2023: 25 · 2022: 27 · 2021: 30 · 2020: 20 · 2019: 10
- FWCI
- 16.56
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIH (K24DK078772, K23DK122104, K23DK099422, K24DK098311, R01 CA137178, 5P30DK046200-25)
- NCI
- AASLD
- Topics
- Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
- Health Sciences › Medicine › Hepatology › Liver physiology and pathology
- Keywords
- aspirin, non-alcoholic fatty liver disease, liver fibrosis progression, nonalcoholic steatohepatitis, nonsteroidal anti-inflammatory drugs, NSAID use, FIB-4, NAFLD fibrosis score, aspartate aminotransferase to platelet ratio index
- MeSH terms
- Duration of Therapy, Adult, Aged, Aspartate Aminotransferases, Aspirin, Female, Humans, Liver Cirrhosis, Male, Middle Aged, Platelet Aggregation Inhibitors, Platelet Count, Prospective Studies, Cohort Studies, Multivariate Analysis, Logistic Models, Proportional Hazards Models, Disease Progression, Non-alcoholic Fatty Liver Disease, Protective Factors
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