Umair Iqbal1, Brittany B Dennis2, Andrew A Li3, George Cholankeril4, Donghee Kim4, Muhammad Ali Khan5, Aijaz Ahmed4. 1. Department of Medicine, Geisinger Commonwealth School of Medicine, 100 North Academy Avenue, Danville, PA, 17821, USA. uiqbal@geisinger.edu. 2. St. George's Hospital Medical School, University of London, London, UK. 3. Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA. 4. Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA. 5. Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, AL, USA.
Abstract
BACKGROUND AND AIMS: While the association between platelet activation and hepatic fibrosis has been previously demonstrated in animal studies; the utility of anti-platelet agents in reversing the progression of hepatic fibrosis requires further review. Utilizing systematic review methods, we provide to our knowledge the first meta-analysis combining evidence from all studies aimed to establish the effect of anti-platelet agents in the prevention of hepatic fibrosis. METHODS: We searched Medline, EMBASE and PubMed databases from inception to October 2018 to identify all studies aimed at evaluating the role of anti-platelet agents in the prevention of hepatic fibrosis. The primary outcome was hepatic fibrosis. The initial title, abstract, and full-text screening were performed in duplicate. Risk of bias was evaluated using the Newcastle-Ottawa Scale. A fixed-effect generic inverse variance method was used to create a pooled estimate of the odds of hepatic fibrosis in patients with anti-platelet agents versus without anti-platelet agents. RESULTS: Among the 2310 unique articles identified during the title screening, 4 studies with a combined population of 3141 patients were deemed eligible for inclusion into the meta-analysis establishing the effect of anti-platelet agents on hepatic fibrosis. One study failed to report their findings in the entire cohort, electing to instead summarize the effects of anti-platelets within subgroups categorized by fibrotic risk factors. Use of anti-platelets was associated with 32% decreased odds of hepatic fibrosis, (adjusted pooled OR 0.68; CI 0.56-0.82, p ≤ 0.0001). The statistical heterogeneity among the studies was insignificant. CONCLUSION: Use of anti-platelet agents is associated with the decreased odds of hepatic fibrosis. Due to limited evidence, future high-quality randomized controlled trials with larger comparative samples are required to further delineate the potential beneficial effects of these drugs in preventing hepatic fibrosis.
BACKGROUND AND AIMS: While the association between platelet activation and hepatic fibrosis has been previously demonstrated in animal studies; the utility of anti-platelet agents in reversing the progression of hepatic fibrosis requires further review. Utilizing systematic review methods, we provide to our knowledge the first meta-analysis combining evidence from all studies aimed to establish the effect of anti-platelet agents in the prevention of hepatic fibrosis. METHODS: We searched Medline, EMBASE and PubMed databases from inception to October 2018 to identify all studies aimed at evaluating the role of anti-platelet agents in the prevention of hepatic fibrosis. The primary outcome was hepatic fibrosis. The initial title, abstract, and full-text screening were performed in duplicate. Risk of bias was evaluated using the Newcastle-Ottawa Scale. A fixed-effect generic inverse variance method was used to create a pooled estimate of the odds of hepatic fibrosis in patients with anti-platelet agents versus without anti-platelet agents. RESULTS: Among the 2310 unique articles identified during the title screening, 4 studies with a combined population of 3141 patients were deemed eligible for inclusion into the meta-analysis establishing the effect of anti-platelet agents on hepatic fibrosis. One study failed to report their findings in the entire cohort, electing to instead summarize the effects of anti-platelets within subgroups categorized by fibrotic risk factors. Use of anti-platelets was associated with 32% decreased odds of hepatic fibrosis, (adjusted pooled OR 0.68; CI 0.56-0.82, p ≤ 0.0001). The statistical heterogeneity among the studies was insignificant. CONCLUSION: Use of anti-platelet agents is associated with the decreased odds of hepatic fibrosis. Due to limited evidence, future high-quality randomized controlled trials with larger comparative samples are required to further delineate the potential beneficial effects of these drugs in preventing hepatic fibrosis.
Authors: Juliet Emamaullee; Sara Khan; Carly Weaver; Cameron Goldbeck; George Yanni; Rohit Kohli; Yuri Genyk; Shengmei Zhou; Nick Shillingford; Patrick M Sullivan; Cheryl Takao; Jon Detterich; Paul F Kantor; John D Cleveland; Cynthia Herrington; S Ram Kumar; Vaughn Starnes; Sarah Badran; Neil D Patel Journal: JHEP Rep Date: 2021-09-14
Authors: Marion Mussbacher; Laura Brunnthaler; Anja Panhuber; Patrick Starlinger; Alice Assinger Journal: Int J Mol Sci Date: 2021-03-18 Impact factor: 5.923
Authors: Preeti Kanikarla Marie; Natalie W Fowlkes; Vahid Afshar-Kharghan; Stephanie L Martch; Alexey Sorokin; John Paul Shen; Van K Morris; Arvind Dasari; Nancy You; Anil K Sood; Michael J Overman; Scott Kopetz; David George Menter Journal: Front Oncol Date: 2021-07-21 Impact factor: 6.244