HBV: daily aspirin therapy is tied to 29% lower HCC risk

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

  • International Clinical Digest
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Takeaway

  • Daily aspirin therapy may reduce the risk for HBV-related hepatocellular carcinoma (HCC).

Why this matters

  • Antiviral therapy reduces but does not eliminate HCC risk.

Study design

  • Taiwanese HBV cohort study of 2123 continuous aspirin users (≥90 days), propensity-matched 1:4 with 8492 patients who had never received antiplatelet therapy.
  • Mean age, 58.8±11.8 years; 72.4% were male.
  • Matching included follow-up index date, baseline characteristics, potential chemopreventive drug use.
  • Funding: Ministry of Science and Technology; National Health Research Institutes; Taichung Veterans General Hospital, Taiwan.

Key results

  • Median duration of aspirin therapy, 3.1 years; 98.0% took ≤100 mg/day, and 82.2% had high-risk factors for cardiovascular diseases.
    • Aspirin was not associated with an increased incidence of peptic ulcer bleeding (6.13% vs 5.52%; P=.09).
  • Cumulative 5-year HCC rate was lower with aspirin treatment (5.20% vs 7.87%; P<.001>
  • Multivariate analysis tied aspirin use to a 29% lower risk for HCC (HR, 0.71; P<.001 verified in various sensitivity analyses.>
  • Other protective factors included use of nucleos(t)ide analogs (HR, 0.54; P<.001 and statins p=".01).</li">
  • Risk factors included older age (HR, 1.01 per year; P=.001), male sex (HR, 1.75; P<.001 and cirrhosis p>

Limitations

  • Observational.
  • Possibly not generalizable to younger patients.
  • Viral load not captured.

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