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The prognostic value of HVPG-response to non-selective beta-blockers in patients with NASH cirrhosis and varices

Paternostro, Rafael, Becker, Jeannette, Hofer, Benedikt Silvester, Panagl, Vera, Schiffke, Helena, Simbrunner, Benedikt, Semmler, Georg, Schwabl, Philipp, Scheiner, Bernhard, Bucsics, Theresa, Bauer, David, Binter, Teresa, Trauner, Michael, Mandorfer, Mattias, Reiberger, Thomas·2022·Digestive and Liver Disease
DOI 10.1016/j.dld.2021.09.009
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Abstract

Background and aims Non-alcoholic steatohepatitis has become a leading cause of cirrhosis. The prognostic value of (HVPG)-guided NSBB prophylaxis remains to be investigated in the setting of NASH cirrhosis. Methods Patients with NASH cirrhosis and varices undergoing HVPG-guided NSBB therapy were included. HVPG-response to NSBBs was evaluated within a median 52 (IQR:28-71) days after baseline measurement. HVPG-Response was defined as a decrease of ≥10% from baseline or below Results Thirtyeight patients were included: Child-A/B:33(87%), Child-C:5(13%) median HVPG:19.7 ± 4.7 mmHg. 21(55.3%) patients achieved HVPG-response to NSBB. Presence of diabetes(aOR:0.16, p = 0.038) and arterial blood pressure (aOR:1.07, p = 0.044) were independently associated with NSBB-response. While NSBB-HVPG-responders showed fewer decompensations within 90 days (n = 1(5%) vs. n = 3(29%), p = 0.172), only Child-Pugh stage B/C (p = 0.001), MELD ≥ 15(p = 0.021) and HVPG ≥ 20 mmHg(p = 0.011) predicted the composite endpoint at 90 days. Similarly, after 2years of follow-up, only Child-Pugh stage (B:p = 0.001, C:p Conclusion HVPG-response to NSBB was achieved in 55.3% of NASH patients with varices and this seemed to protect from variceal bleeding. However, only baseline HVPG ≥ 20 mmHg, Child-Pugh stage B/C and MELD ≥ 15 were predictors of decompensation/death in patients with NASH cirrhosis and varices.

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Research works printed but not linked: 45

  1. Pimpin, 2018, Burden of liver disease in Europe: epidemiology and analysis of risk factors to identify prevention policies, J Hepatol, 69, 718, 10.1016/j.jhep.2018.05.011 · DOI
  2. Younossi, 2018, Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention, Nat Rev Gastroenterol Hepatol, 15, 11, 10.1038/nrgastro.2017.109 · DOI · Paper page
  3. Goldberg, 2017, Changes in the prevalence of hepatitis C virus infection, nonalcoholic steatohepatitis, and alcoholic liver disease among patients with cirrhosis or liver failure on the waitlist for liver transplantation, Gastroenterology, 152, 1090, 10.1053/j.gastro.2017.01.003 · DOI
  4. Garcia-Tsao, 2017, Portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis, and management: 2016 practice guidance by the American association for the study of liver diseases, Hepatology, 65, 310, 10.1002/hep.28906 · DOI · Paper page
  5. Reiberger, 2017, Austrian consensus guidelines on the management and treatment of portal hypertension (Billroth III), Wien Klin Wochenschr, 129, 135, 10.1007/s00508-017-1262-3 · DOI
  6. D'Amico, 2018, Clinical states of cirrhosis and competing risks, J Hepatol, 68, 563, 10.1016/j.jhep.2017.10.020 · DOI · Paper page
  7. Groszmann, 2005, Beta-blockers to prevent gastroesophageal varices in patients with cirrhosis, N Engl J Med, 353, 2254, 10.1056/NEJMoa044456 · DOI
  8. Bosch, 2003, Prevention of variceal rebleeding, Lancet, 361, 952, 10.1016/S0140-6736(03)12778-X · DOI
  9. Merkel, 2000, The hemodynamic response to medical treatment of portal hypertension as a predictor of clinical effectiveness in the primary prophylaxis of variceal bleeding in cirrhosis, Hepatology, 32, 930, 10.1053/jhep.2000.19322 · DOI
  10. Abraldes, 2008, Hepatic venous pressure gradient and prognosis in patients with acute variceal bleeding treated with pharmacologic and endoscopic therapy, J Hepatol, 48, 229, 10.1016/j.jhep.2007.10.008 · DOI
  11. Moitinho, 1999, Prognostic value of early measurements of portal pressure in acute variceal bleeding, Gastroenterology, 117, 626, 10.1016/S0016-5085(99)70455-5 · DOI
  12. Reiberger, 2013, Carvedilol for primary prophylaxis of variceal bleeding in cirrhotic patients with haemodynamic non-response to propranolol, Gut, 62, 1634, 10.1136/gutjnl-2012-304038 · DOI
  13. Pfisterer, 2018, Betablockers do not increase efficacy of band ligation in primary prophylaxis but they improve survival in secondary prophylaxis of variceal bleeding, Aliment Pharmacol Ther, 47, 966, 10.1111/apt.14485 · DOI
  14. Sharma, 2019, Comparison of therapies for primary prevention of esophageal variceal bleeding: a systematic review and network meta-analysis, Hepatology, 69, 1657, 10.1002/hep.30220 · DOI
  15. Villanueva, 2019, beta blockers to prevent decompensation of cirrhosis in patients with clinically significant portal hypertension (PREDESCI): a randomised, double-blind, placebo-controlled, multicentre trial, Lancet, 393, 1597, 10.1016/S0140-6736(18)31875-0 · DOI · Paper page
  16. Mandorfer, 2014, Nonselective beta blockers increase risk for hepatorenal syndrome and death in patients with cirrhosis and spontaneous bacterial peritonitis, Gastroenterology, 146, 1680, 10.1053/j.gastro.2014.03.005 · DOI
  17. Mandorfer, 2017, Beta blockers and cirrhosis, 2016, Dig Liver Dis, 49, 3, 10.1016/j.dld.2016.09.013 · DOI
  18. Mandorfer, 2019, Hepatic venous pressure gradient response in non-selective beta-blocker treatment—is it worth measuring?, Curr Hepatol Rep, 18, 174, 10.1007/s11901-019-00469-x · DOI
  19. de Franchis, 2015, Expanding consensus in portal hypertension: report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension, J Hepatol, 63, 743, 10.1016/j.jhep.2015.05.022 · DOI · Paper page
  20. Sourianarayanane, 2017, Stage of fibrosis and portal pressure correlation in nonalcoholic steatohepatitis, Eur J Gastroenterol Hepatol, 29, 516, 10.1097/MEG.0000000000000825 · DOI
  21. Schwarzer, 2018, Carvedilol for reducing portal pressure in primary prophylaxis of variceal bleeding: a dose-response study, Aliment Pharmacol Ther, 47, 1162, 10.1111/apt.14576 · DOI
  22. Reiberger, 2020, Measurement of the hepatic venous pressure gradient and transjugular liver biopsy, J Vis Exp, 18, 10.3791/58819 · DOI
  23. Ferlitsch, 2015, Evaluation of a new balloon occlusion catheter specifically designed for measurement of hepatic venous pressure gradient, Liver Int, 10.1111/liv.12783 · DOI
  24. Banares, 2002, Randomized comparison of long-term carvedilol and propranolol administration in the treatment of portal hypertension in cirrhosis, Hepatology, 36, 1367, 10.1002/hep.1840360612 · DOI
  25. Kim, 2016, A randomized, multi-center, open-label study to evaluate the efficacy of carvedilol vs. propranolol to reduce portal pressure in patients with liver cirrhosis, Am J Gastroenterol, 111, 1582, 10.1038/ajg.2016.327 · DOI
  26. Banares, 1999, Carvedilol, a new nonselective beta-blocker with intrinsic anti- alpha1-adrenergic activity, has a greater portal hypotensive effect than propranolol in patients with cirrhosis, Hepatology, 30, 79, 10.1002/hep.510300124 · DOI
  27. Lonardo, 2018, Hypertension, diabetes, atherosclerosis and NASH: cause or consequence?, J Hepatol, 68, 335, 10.1016/j.jhep.2017.09.021 · DOI
  28. Hsu, 2018, Development of a scoring system to predict hepatocellular carcinoma in Asians on antivirals for chronic hepatitis B, J Hepatol, 69, 278, 10.1016/j.jhep.2018.02.032 · DOI
  29. Huang, 2014, Increased risk of cirrhosis and its decompensation in chronic hepatitis C patients with new-onset diabetes: a nationwide cohort study, Hepatology, 60, 807, 10.1002/hep.27212 · DOI
  30. Elkrief, 2014, Diabetes mellitus is an independent prognostic factor for major liver-related outcomes in patients with cirrhosis and chronic hepatitis C, Hepatology, 60, 823, 10.1002/hep.27228 · DOI
  31. Tergast, 2018, Association between type 2 diabetes mellitus, HbA1c and the risk for spontaneous bacterial peritonitis in patients with decompensated liver cirrhosis and ascites, Clin Transl Gastroenterol, 9, 189, 10.1038/s41424-018-0053-0 · DOI
  32. Cheuk-Fung Yip, 2018, Effects of diabetes and glycemic control on risk of hepatocellular carcinoma after seroclearance of hepatitis B surface antigen, Clin Gastroenterol Hepatol, 16, 765, 10.1016/j.cgh.2017.12.009 · DOI
  33. Luca, 1997, Effects of ethanol consumption on hepatic hemodynamics in patients with alcoholic cirrhosis, Gastroenterology, 112, 1284, 10.1016/S0016-5085(97)70142-2 · DOI
  34. Mehta, 2015, Systemic inflammation is associated with increased intrahepatic resistance and mortality in alcohol-related acute-on-chronic liver failure, Liver Int, 35, 724, 10.1111/liv.12559 · DOI
  35. Mandorfer, 2016, Sustained virologic response to interferon-free therapies ameliorates HCV-induced portal hypertension, J Hepatol, 65, 692, 10.1016/j.jhep.2016.05.027 · DOI
  36. Mandorfer, 2020, Changes in hepatic venous pressure gradient predict hepatic decompensation in patients who achieved sustained virologic response to interferon-free therapy, Hepatology, 71, 1023, 10.1002/hep.30885 · DOI
  37. Vilar-Gomez, 2018, Fibrosis severity as a determinant of cause-specific mortality in patients with advanced nonalcoholic fatty liver disease: a multi-national cohort Study, Gastroenterology, 155, 443, 10.1053/j.gastro.2018.04.034 · DOI · Paper page
  38. Krag, 2012, The window hypothesis: haemodynamic and non-haemodynamic effects of β-blockers improve survival of patients with cirrhosis during a window in the disease, Gut, 61, 967, 10.1136/gutjnl-2011-301348 · DOI
  39. Reiberger, 2017, Beta adrenergic blockade and decompensated cirrhosis, J Hepatol, 66, 849, 10.1016/j.jhep.2016.11.001 · DOI
  40. Sersté, 2010, Deleterious effects of beta-blockers on survival in patients with cirrhosis and refractory ascites, Hepatology, 52, 1017, 10.1002/hep.23775 · DOI
  41. Sebastiani, 2015, Prognostic value of non-invasive fibrosis and steatosis tools, hepatic venous pressure gradient (HVPG) and Histology in nonalcoholic steatohepatitis, PLoS ONE, 10, 10.1371/journal.pone.0128774 · DOI
  42. Turco, 2020, Lowering portal pressure improves outcomes of patients with cirrhosis, with or without ascites: a meta-analysis, Clin Gastroenterol Hepatol, 18, 313, 10.1016/j.cgh.2019.05.050 · DOI
  43. Reiberger, 2018, Small esophageal varices in patients with cirrhosis-should we treat them?, Curr Hepatol Rep, 17, 301, 10.1007/s11901-018-0420-z · DOI
  44. Villanueva, 2016, Development of hyperdynamic circulation and response to β-blockers in compensated cirrhosis with portal hypertension, Hepatology, 63, 197, 10.1002/hep.28264 · DOI
  45. Téllez, 2020, Non-selective beta-blockers impair global circulatory homeostasis and renal function in cirrhotic patients with refractory ascites, J Hepatol, 73, 1404, 10.1016/j.jhep.2020.05.011 · DOI

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Metadata

Authors
Paternostro, R., Becker, J., Hofer, B. S., Panagl, V., Schiffke, H., Simbrunner, B., Semmler, G., Schwabl, P., Scheiner, B., Bucsics, T., Bauer, D., Binter, T., Trauner, M., Mandorfer, M., & Reiberger, T.
ORCID
Reiberger, Thomas
Venue
Digestive and Liver Disease
Publisher
Elsevier BV
Published
2022-04
Volume
54
Issue
4
Pages
500-508
ISSN
1590-8658
DOI
10.1016/j.dld.2021.09.009
Cited by
17
References
3
Language
en
Licence
Funders
  • Bayer
  • Medizinische Universität Graz
  • Roche
  • Boehringer Ingelheim
  • Gilead Sciences
  • AbbVie
  • Meso Scale Diagnostics
  • Bristol-Myers Squibb

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