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Renin-angiotensin System Inhibitors and Development of Hepatocellular Carcinoma: A Systematic Review and Meta-analysis

Author(s):

Fereshteh Asgharzadeh, Reza Jafarzadeh-Esfehani, Seyed Mahdi Hassanian, Gordon A Ferns, Amir Avan and Majid Khazaei*   Pages 1 - 7 ( 7 )

Abstract:


Background: There are controversial results available about using angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) and the development of cancers or improvement of clinical outcomes. Studies reported that using ACEI/ARB may enhance the development of hepatocellular carcinoma (HCC) and clinical outcomes.

Objective: This meta-analysis aimed to assess the relationship between ACEI/ARB therapy and the development of HCC.

Methods: PubMed, EMBASE and the Cochrane library were reviewed to identify clinical studies investigating the association between ACEI/ARB therapy and the risk of HCC development. The pooled risk ratio (RR) with 95% confidence intervals collected for the association between using ACEIs/ARBs and HCC development.

Results: Patients with HCC benefit from treatment with both ACEIs and ARBs (RR 0.704, 95% CI 0.526-0.944, p = 0.019). However, only using ARBs was related to HCC risk (0.545 95% CI 0.470-0.632, P<0.0001). Moreover, the study types were significantly related to the observed effects of using both ARBs and ACEIs. Only cohort studies were significantly related to achieving better results (RR=0.513, 95% CI= 0.442-0.597, P<0.0001).

Conclusion: Despite the small number and heterogeneity of the studies evaluating the relationship between treatment with ARBs and ACEIs and the development of HCC, our meta-analysis demonstrates that they may reduce the risk of HCC.

Keywords:

Angiotensin receptor blocker, Angiotensin-converting enzyme inhibitor, Hepatocellular carcinoma, Therapy

Affiliation:

Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Department of Medical Genetics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Metabolic syndrome Research center, Mashhad University of Medical Sciences, Mashhad, Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad



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