Daily aspirin therapy tied to lower hepatocellular carcinoma risk in patients with chronic hepatitis B

  • Lee TY & al.
  • JAMA Intern Med
  • 18 Mar 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Study suggests that daily aspirin therapy may be associated with a reduction in the risk for hepatocellular carcinoma (HCC) development in patients with chronic hepatitis B.

Why this matters

  • Findings suggest that daily aspirin therapy may be of help in future efforts to further improve the chemoprevention of hepatitis B virus-related HCC.

Study design

  • Patients who received continuous aspirin therapy (n=2123, treated group) were randomly matched 1:4 with those who had never received aspirin (n=8492, untreated group) by means of propensity scores (mean age, 58.8 years).
  • Main outcome: occurrence of HCC.
  • Funding: Ministry of Science and Technology, National Health Research Institutes, and Taichung Veterans General Hospital, Taiwan.

Key results

  • Cumulative incidence of HCC was significantly lower in the treated group vs untreated group in 5 years (5.20% [95% CI, 4.11-6.29%] vs 7.87% [95% CI, 7.15-8.60%]; P<.001>
  • Aspirin therapy showed independent association with a reduced HCC risk in multivariate regression analysis (HR, 0.71; 95% CI, 0.58-0.86; P<.001>
  • Factors associated with higher HCC risk included:
    • older age (HR, 1.01; 95% CI, 1.00-1.02; P=.001);
    • male sex (HR, 1.75; 95% CI, 1.43-2.14; P<.001 and>
    • liver cirrhosis (HR, 2.89; 95% CI, 2.45-3.40; P<.001>
  • Use of nucleos(t)ide analogues (HR, 0.54; 95% CI, 0.41-0.71; P

Limitations

  • Observational design.
  • Results may not be generalisable to younger patients.