In hepatitis B and C, aspirin use is tied to lower HCC risk

  • Simon TG & al.
  • N Engl J Med
  • 12 Mar 2020

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • A Swedish population study shows that low-dose aspirin use is linked to a lower incidence of hepatocellular carcinoma (HCC) among patients with chronic hepatitis B and C.

Why this matters

  • Mechanistic studies suggest a protective effect, but observational data in the US and Europe have been flawed.

Study design

  • Propensity-score-matched analysis from Swedish registries of patients who were prescribed 90 or more doses of low-dose (75 or 160 mg) aspirin (n=50,275).
  • Funding: National Institutes of Health; others.

Key results

  • Median follow-up, 7.9 years.
  • Aspirin use was associated with an HCC incidence of 4.0% compared with 8.3% in nonusers:
    • Adjusted (a)HR, 0.69 (95% CI, 0.62-0.76).
  • Longer use was associated with lower incidence compared with short-term use (3 months to
  • 1 to
  • 3 to
  • ≥5 years: aHR, 0.57 (95% CI, 0.42-0.70).
  • 10-year liver-related mortality was lower among aspirin users:
    • 11.0% vs 17.9%;
    • aHR, 0.73 (95% CI, 0.67-0.81).
  • There was no difference in 10-year risk for gastrointestinal bleeding:
    • 7.8% in users vs 6.9% in nonusers;
    • Difference, 0.9% (95% CI, −0.6% to 2.4%).
  • Limitations

    • Retrospective analysis.
    • Swedish population.