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Hepatol Int. 2019 Jan;13(1):84-90. doi: 10.1007/s12072-018-9918-2. Epub 2018 Dec 12.

Use of anti-platelet agents in the prevention of hepatic fibrosis in patients at risk for chronic liver disease: a systematic review and meta-analysis.

Author information

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, pā€‰ā‰¤ā€‰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.

KEYWORDS:

Anti-platelets; Aspirin; Hepatic fibrosis; Systematic review

PMID:
30539518
PMCID:
PMC6675411
DOI:
10.1007/s12072-018-9918-2
[Indexed for MEDLINE]
Free PMC Article

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