caa a22 4500 44579741X CHVBK 20180317145130.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1007/s10620-010-1507-8 doi (NATIONALLICENCE)springer-10.1007/s10620-010-1507-8 The Effects of Angiotensin Blocking Agents on the Progression of Liver Fibrosis in the HALT-C Trial Cohort [Elektronische Daten] [Barham Abu Dayyeh, May Yang, Jules Dienstag, Raymond Chung] Background: Therapies that can slow the progression of liver fibrosis in chronic liver disease are needed. Evidence suggests that the renin-angiotensin system (RAS) contributes to inflammation and fibrosis in chronic liver disease. Both animal and limited human studies have shown that RAS inhibition with angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor-1 [AT-1] blockers (ARBs) has antifibrogenic properties. Aims: In this study, we evaluated the effects of continuous ACEi/ARB use for 3.5years on histological liver fibrosis progression in the HALT-C Trial cohort. Methods: In the HALT-C Trial, subjects with chronic hepatitis C and advanced hepatic fibrosis (Ishak stage ≥3) underwent serial liver biopsies at baseline, 1.5years, and 3.5years after randomization. The primary outcome was a ≥2-point increase in Ishak fibrosis score in at least one of the two serial biopsies. Sixty-six subjects were continuously taking ACEi/ARBs over the observation period, 126 were taking other antihypertensive medications, and 343 subjects took no antihypertensive medications. Results: The three groups were similar in baseline fibrosis scores, and the two groups being treated with antihypertensives were taking a similar number of antihypertensive medications. Fibrosis progression occurred in 33.3% of the ACEi/ARB group, 32.5% of the other antihypertensive medications group, and in 25.7% of subjects taking no antihypertensive medications. No significant associations between ≥2-point increases in fibrosis scores and continuous ACEi/ARB use were apparent at either 1.5 or 3.5years in diabetes-adjusted and unadjusted odds ratios. Conclusions: ACEi/ARB therapy did not retard the progression of hepatic fibrosis. Springer Science+Business Media, LLC, 2010 Renin-angiotensin system nationallicence ACE inhibitors nationallicence Angiotensin receptor blockers nationallicence Liver fibrosis nationallicence Hypertension nationallicence Diabetes nationallicence ACEi : Angiotensin-converting enzyme inhibitors nationallicence ARBs : Angiotensin receptor blockers nationallicence HALT-C : Hepatitis C Long-term Treatment Against Cirrhosis nationallicence HSC : Stellate cells nationallicence OR : Odds ratio nationallicence RAS : Renin-angiotensin system nationallicence SVR : Sustained virologic response nationallicence Abu Dayyeh Barham Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Blake 4, 55 Fruit Street, 02114, Boston, MA, USA aut Yang May New England Research Institutes, 9 Galen Street, 02472, Watertown, MA, USA aut Dienstag Jules Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Warren 1007A, 55 Fruit Street, 02114, Boston, MA, USA aut Chung Raymond Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Warren 1007C, 55 Fruit Street, 02114, Boston, MA, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/2(2011-02-01), 564-568 0163-2116 56:2<564 2011 56 10620 https://doi.org/10.1007/s10620-010-1507-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-010-1507-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Abu Dayyeh Barham Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Blake 4, 55 Fruit Street, 02114, Boston, MA, USA aut NATIONALLICENCE 700 1- Yang May New England Research Institutes, 9 Galen Street, 02472, Watertown, MA, USA aut NATIONALLICENCE 700 1- Dienstag Jules Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Warren 1007A, 55 Fruit Street, 02114, Boston, MA, USA aut NATIONALLICENCE 700 1- Chung Raymond Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Warren 1007C, 55 Fruit Street, 02114, Boston, MA, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/2(2011-02-01), 564-568 0163-2116 56:2<564 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer