New treatment to mitigate cirrhosis

Cirrhosis is a state that the liver reaches as a result of one of several liver diseases. Broadly speaking, the architecture of the liver is altered in a way that prevents it from performing its functions normally. Many people in the world suffer from cirrhosis. The only definitive cure is a liver transplant, but a shortage of donors means that only a few patients benefit from this therapy each year, and many others die.

Carvedilol, a drug belonging to the group of beta-blockers, can prevent cirrhosis decompensation and improve survival in patients with compensated cirrhosis. This is demonstrated by a study carried out by a team from the Hospital de la Santa Creu i Sant Pau in Barcelona, ​​the Sant Pau Biomedical Research Institute (IIB Sant Pau) in Barcelona, ​​the Autonomous University of Barcelona (UAB) and the Biomedical Research Center in the Network of Liver and Digestive Diseases (CIBEREHD), in Spain.

Carvedilol is a drug whose action causes blood vessels to relax and widen. Because of this intrinsic vasodilator activity, it can improve hepatic vascular resistance, an important mechanism of portal hypertension in early cirrhosis. “Portal hypertension is a main determinant of the progression of cirrhosis from compensated to decompensated, with the consequent increase in morbidity and worsening of life expectancy”, explains Jaume Bosch, CIBEREHD researcher and one of the coordinators of this work. . Therefore “it is important to clarify the potential effect of these beta-blockers to prevent this decompensation,” he adds.

James Bosch. (Photo: CIBEREHD)

In this way, this team of researchers evaluated, through a systematic review of studies, the usefulness of carvedilol to prevent decompensation and improve survival in compensated cirrhosis with clinically significant portal hypertension (CSPH). The analysis included data from 352 patients with compensated cirrhosis, 181 treated with carvedilol and 171 who were not treated with carvedilol (control group).

“The data show that carvedilol significantly reduces the risk of decompensation in patients with cirrhosis and CSPH, mainly by reducing the probability of developing ascites (accumulation of fluid in the abdominal cavity)”, details Candid Villanueva, one of the main authors of the work. . And what is even more important, “carvedilol significantly improves survival in compensated patients.”

Therefore, “our findings suggest that screening for CSPH in patients with compensated cirrhosis to initiate carvedilol therapy may prevent progression from compensated to decompensated cirrhosis,” the researchers conclude.

The study is titled “Carvedilol reduces the risk of decompensation and mortality in patients with compensated cirrhosis in a competing-risk meta-analysis.” And it has been published in the academic journal Journal of Hepatology. (Source: CIBEREHD)