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Tenofovir vs. entecavir: Better therapeutic in HBV-related HCC after radiofrequency ablation
Key clinical point: In patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) who had undergone radiofrequency ablation (RFA), tenofovir disoproxil fumarate (TDF) performed better at protecting liver function and reducing HBV DNA loads than entecavir (ETV), without significant difference in recurrence or overall survival.
Major finding: Patients receiving TDF vs. ETV showed significantly faster serum HBV DNA reduction (2.75 vs. 9.13 months; P = .015) and a higher stabilization/improvement rate of the albumin-bilirubin grade (64% vs. 41%; P < .001), but similar 5-year recurrence (40.3% vs. 40.8%; P = .35) and overall survival (93.5% vs. 96.9%; P = .12) rates.
Study details: This single-center retrospective cohort study propensity score-matched patients receiving ETV (n = 130) with those receiving TDF (n = 77) for chronic HBV infection after undergoing RFA as a curative treatment for HCC.
Disclosures: The study was funded by the National Natural Science Foundation of China and Sun Yat-sen University Cancer Center physician scientist funding. No conflicts of interest were reported.
Source: Hu Z et al. Tenofovir vs. entecavir on outcomes of hepatitis B virus-related hepatocellular carcinoma after radiofrequency ablation. Viruses. 2022;14(4):656 (Mar 22). Doi: 10.3390/v14040656
Key clinical point: In patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) who had undergone radiofrequency ablation (RFA), tenofovir disoproxil fumarate (TDF) performed better at protecting liver function and reducing HBV DNA loads than entecavir (ETV), without significant difference in recurrence or overall survival.
Major finding: Patients receiving TDF vs. ETV showed significantly faster serum HBV DNA reduction (2.75 vs. 9.13 months; P = .015) and a higher stabilization/improvement rate of the albumin-bilirubin grade (64% vs. 41%; P < .001), but similar 5-year recurrence (40.3% vs. 40.8%; P = .35) and overall survival (93.5% vs. 96.9%; P = .12) rates.
Study details: This single-center retrospective cohort study propensity score-matched patients receiving ETV (n = 130) with those receiving TDF (n = 77) for chronic HBV infection after undergoing RFA as a curative treatment for HCC.
Disclosures: The study was funded by the National Natural Science Foundation of China and Sun Yat-sen University Cancer Center physician scientist funding. No conflicts of interest were reported.
Source: Hu Z et al. Tenofovir vs. entecavir on outcomes of hepatitis B virus-related hepatocellular carcinoma after radiofrequency ablation. Viruses. 2022;14(4):656 (Mar 22). Doi: 10.3390/v14040656
Key clinical point: In patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) who had undergone radiofrequency ablation (RFA), tenofovir disoproxil fumarate (TDF) performed better at protecting liver function and reducing HBV DNA loads than entecavir (ETV), without significant difference in recurrence or overall survival.
Major finding: Patients receiving TDF vs. ETV showed significantly faster serum HBV DNA reduction (2.75 vs. 9.13 months; P = .015) and a higher stabilization/improvement rate of the albumin-bilirubin grade (64% vs. 41%; P < .001), but similar 5-year recurrence (40.3% vs. 40.8%; P = .35) and overall survival (93.5% vs. 96.9%; P = .12) rates.
Study details: This single-center retrospective cohort study propensity score-matched patients receiving ETV (n = 130) with those receiving TDF (n = 77) for chronic HBV infection after undergoing RFA as a curative treatment for HCC.
Disclosures: The study was funded by the National Natural Science Foundation of China and Sun Yat-sen University Cancer Center physician scientist funding. No conflicts of interest were reported.
Source: Hu Z et al. Tenofovir vs. entecavir on outcomes of hepatitis B virus-related hepatocellular carcinoma after radiofrequency ablation. Viruses. 2022;14(4):656 (Mar 22). Doi: 10.3390/v14040656
Unresectable HCC: Suboptimal response to lenvatinib plus pembrolizumab beyond the first-line setting
Key clinical point: Although lenvatinib plus pembrolizumab exhibits similar tolerability between systemic therapy-naive and -experienced patients with unresectable hepatocellular carcinoma (uHCC), the progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR) may be compromised in patients with prior systemic therapy.
Major finding: After a 9.3-month median follow-up, therapy-naive vs. -experienced patients showed numerically greater median PFS (9.2 vs. 4.9 months; P = .092), ORR (34.1% vs. 18.5%; P = .157), and DCR (84.1% vs. 70.4%; P = .169), but similar incidence rates of treatment-emergent adverse events (96.4% vs. 97.7%).
Study details: Findings are from a prospective study that enrolled 71 patients with uHCC who were systemic therapy-naive (n = 44) or -experienced (n =2 7) and received lenvatinib plus pembrolizumab.
Disclosures: The study received financial support from Taipei Veteran General Hospital, Taiwan. The authors declared no conflicts of interest.
Source: Wu C-J et al. Lenvatinib plus pembrolizumab for systemic therapy-naïve and -experienced unresectable hepatocellular carcinoma. Cancer Immunol Immunother. 2022 (Mar 28). Doi: 10.1007/s00262-022-03185-6
Key clinical point: Although lenvatinib plus pembrolizumab exhibits similar tolerability between systemic therapy-naive and -experienced patients with unresectable hepatocellular carcinoma (uHCC), the progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR) may be compromised in patients with prior systemic therapy.
Major finding: After a 9.3-month median follow-up, therapy-naive vs. -experienced patients showed numerically greater median PFS (9.2 vs. 4.9 months; P = .092), ORR (34.1% vs. 18.5%; P = .157), and DCR (84.1% vs. 70.4%; P = .169), but similar incidence rates of treatment-emergent adverse events (96.4% vs. 97.7%).
Study details: Findings are from a prospective study that enrolled 71 patients with uHCC who were systemic therapy-naive (n = 44) or -experienced (n =2 7) and received lenvatinib plus pembrolizumab.
Disclosures: The study received financial support from Taipei Veteran General Hospital, Taiwan. The authors declared no conflicts of interest.
Source: Wu C-J et al. Lenvatinib plus pembrolizumab for systemic therapy-naïve and -experienced unresectable hepatocellular carcinoma. Cancer Immunol Immunother. 2022 (Mar 28). Doi: 10.1007/s00262-022-03185-6
Key clinical point: Although lenvatinib plus pembrolizumab exhibits similar tolerability between systemic therapy-naive and -experienced patients with unresectable hepatocellular carcinoma (uHCC), the progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR) may be compromised in patients with prior systemic therapy.
Major finding: After a 9.3-month median follow-up, therapy-naive vs. -experienced patients showed numerically greater median PFS (9.2 vs. 4.9 months; P = .092), ORR (34.1% vs. 18.5%; P = .157), and DCR (84.1% vs. 70.4%; P = .169), but similar incidence rates of treatment-emergent adverse events (96.4% vs. 97.7%).
Study details: Findings are from a prospective study that enrolled 71 patients with uHCC who were systemic therapy-naive (n = 44) or -experienced (n =2 7) and received lenvatinib plus pembrolizumab.
Disclosures: The study received financial support from Taipei Veteran General Hospital, Taiwan. The authors declared no conflicts of interest.
Source: Wu C-J et al. Lenvatinib plus pembrolizumab for systemic therapy-naïve and -experienced unresectable hepatocellular carcinoma. Cancer Immunol Immunother. 2022 (Mar 28). Doi: 10.1007/s00262-022-03185-6
Preliminary results call for evaluating AtezoBev in unresectable HCC beyond the CP-A criteria
Key clinical point: Atezolizumab plus bevacizumab (AtezoBev) is an effective therapeutic option for unresectable hepatocellular carcinoma (uHCC) in routine clinical practice and is safe even in patients with Child-Pugh (CP)-B grade liver function.
Major finding: After a 9-month median follow-up, median overall survival was 14.9 months (95% CI 13.6-16.3 months) and median progression-free survival was 6.8 months (95% CI 5.2-8.5 months). Tolerability was similar across CP classes, with comparable bevacizumab-related (CP-A, 48%; CP-B, 46%) and atezolizumab-related (CP-A, 53%; CP-B, 40%) adverse event rates of any grade.
Study details: This was a multicenter retrospective study that included 202 adult patients with uHCC and CP-A (76%) or CP-B (24%) cirrhosis who received AtezoBev as the first-line systemic treatment.
Disclosures: The study was funded by the National Institute of Health Research Imperial Biomedical Research Centre, among others. Some authors declared serving as consultants or advisors for or receiving advisory board honoraria, lecture/speaker fees, research grants, or travel/accommodation expenses from various sources.
Source: D'Alessio A et al. Preliminary evidence of safety and tolerability of atezolizumab plus bevacizumab in patients with hepatocellular carcinoma and Child-Pugh A and B cirrhosis: A real-world study. Hepatology. 2022 (Mar 21). Doi: 10.1002/hep.32468
Key clinical point: Atezolizumab plus bevacizumab (AtezoBev) is an effective therapeutic option for unresectable hepatocellular carcinoma (uHCC) in routine clinical practice and is safe even in patients with Child-Pugh (CP)-B grade liver function.
Major finding: After a 9-month median follow-up, median overall survival was 14.9 months (95% CI 13.6-16.3 months) and median progression-free survival was 6.8 months (95% CI 5.2-8.5 months). Tolerability was similar across CP classes, with comparable bevacizumab-related (CP-A, 48%; CP-B, 46%) and atezolizumab-related (CP-A, 53%; CP-B, 40%) adverse event rates of any grade.
Study details: This was a multicenter retrospective study that included 202 adult patients with uHCC and CP-A (76%) or CP-B (24%) cirrhosis who received AtezoBev as the first-line systemic treatment.
Disclosures: The study was funded by the National Institute of Health Research Imperial Biomedical Research Centre, among others. Some authors declared serving as consultants or advisors for or receiving advisory board honoraria, lecture/speaker fees, research grants, or travel/accommodation expenses from various sources.
Source: D'Alessio A et al. Preliminary evidence of safety and tolerability of atezolizumab plus bevacizumab in patients with hepatocellular carcinoma and Child-Pugh A and B cirrhosis: A real-world study. Hepatology. 2022 (Mar 21). Doi: 10.1002/hep.32468
Key clinical point: Atezolizumab plus bevacizumab (AtezoBev) is an effective therapeutic option for unresectable hepatocellular carcinoma (uHCC) in routine clinical practice and is safe even in patients with Child-Pugh (CP)-B grade liver function.
Major finding: After a 9-month median follow-up, median overall survival was 14.9 months (95% CI 13.6-16.3 months) and median progression-free survival was 6.8 months (95% CI 5.2-8.5 months). Tolerability was similar across CP classes, with comparable bevacizumab-related (CP-A, 48%; CP-B, 46%) and atezolizumab-related (CP-A, 53%; CP-B, 40%) adverse event rates of any grade.
Study details: This was a multicenter retrospective study that included 202 adult patients with uHCC and CP-A (76%) or CP-B (24%) cirrhosis who received AtezoBev as the first-line systemic treatment.
Disclosures: The study was funded by the National Institute of Health Research Imperial Biomedical Research Centre, among others. Some authors declared serving as consultants or advisors for or receiving advisory board honoraria, lecture/speaker fees, research grants, or travel/accommodation expenses from various sources.
Source: D'Alessio A et al. Preliminary evidence of safety and tolerability of atezolizumab plus bevacizumab in patients with hepatocellular carcinoma and Child-Pugh A and B cirrhosis: A real-world study. Hepatology. 2022 (Mar 21). Doi: 10.1002/hep.32468
Adjuvant SBRT after marginal resection: A safe therapeutic option for MVI-positive HCC
Key clinical point: Postoperative adjuvant stereotactic body radiotherapy (SBRT) on suboptimal resection margin safely and effectively improves disease-free survival (DFS) and prevents local recurrence in microvascular invasion (MVI)-positive hepatocellular carcinoma (HCC).
Major finding: SBRT vs. surgery alone led to significantly higher 1-year (92.1% vs. 76.3%) and 5-year (56.1% vs. 26.3%) DFS rates (P = .005) and similar local recurrence (P = .236) rates. No grade ≥3 adverse events were noted.
Study details: This randomized controlled trial included 76 adult patients with MVI-positive HCC who underwent marginal resection and were randomly assigned to receive postoperative adjuvant SBRT or surgery alone.
Disclosures: The study was funded by the Clinical Science and Technology Innovation Project of Shenkang Hospital Development Center, Shanghai Jiading District Fund, and Shanghai Municipal Health Commission Program, China. No conflicts of interest were reported.
Source: Shi C et al. Adjuvant stereotactic body radiotherapy after marginal resection for hepatocellular carcinoma with microvascular invasion: A randomised controlled trial. Eur J Cancer. 2022;166:176-184 (Mar 16). Doi: 10.1016/j.ejca.2022.02.012
Key clinical point: Postoperative adjuvant stereotactic body radiotherapy (SBRT) on suboptimal resection margin safely and effectively improves disease-free survival (DFS) and prevents local recurrence in microvascular invasion (MVI)-positive hepatocellular carcinoma (HCC).
Major finding: SBRT vs. surgery alone led to significantly higher 1-year (92.1% vs. 76.3%) and 5-year (56.1% vs. 26.3%) DFS rates (P = .005) and similar local recurrence (P = .236) rates. No grade ≥3 adverse events were noted.
Study details: This randomized controlled trial included 76 adult patients with MVI-positive HCC who underwent marginal resection and were randomly assigned to receive postoperative adjuvant SBRT or surgery alone.
Disclosures: The study was funded by the Clinical Science and Technology Innovation Project of Shenkang Hospital Development Center, Shanghai Jiading District Fund, and Shanghai Municipal Health Commission Program, China. No conflicts of interest were reported.
Source: Shi C et al. Adjuvant stereotactic body radiotherapy after marginal resection for hepatocellular carcinoma with microvascular invasion: A randomised controlled trial. Eur J Cancer. 2022;166:176-184 (Mar 16). Doi: 10.1016/j.ejca.2022.02.012
Key clinical point: Postoperative adjuvant stereotactic body radiotherapy (SBRT) on suboptimal resection margin safely and effectively improves disease-free survival (DFS) and prevents local recurrence in microvascular invasion (MVI)-positive hepatocellular carcinoma (HCC).
Major finding: SBRT vs. surgery alone led to significantly higher 1-year (92.1% vs. 76.3%) and 5-year (56.1% vs. 26.3%) DFS rates (P = .005) and similar local recurrence (P = .236) rates. No grade ≥3 adverse events were noted.
Study details: This randomized controlled trial included 76 adult patients with MVI-positive HCC who underwent marginal resection and were randomly assigned to receive postoperative adjuvant SBRT or surgery alone.
Disclosures: The study was funded by the Clinical Science and Technology Innovation Project of Shenkang Hospital Development Center, Shanghai Jiading District Fund, and Shanghai Municipal Health Commission Program, China. No conflicts of interest were reported.
Source: Shi C et al. Adjuvant stereotactic body radiotherapy after marginal resection for hepatocellular carcinoma with microvascular invasion: A randomised controlled trial. Eur J Cancer. 2022;166:176-184 (Mar 16). Doi: 10.1016/j.ejca.2022.02.012
Surveillance for HCC occurrence in NAFLD: Why concentrate our efforts?
Key clinical point: Compared with other liver disease etiologies, nonalcoholic fatty liver disease (NAFLD) was associated with lower hepatocellular carcinoma (HCC) surveillance receipt and early-stage detection, thus calling for interventions for increased surveillance implementation and improved prognosis of patients with NAFLD-related HCC.
Major finding: NAFLD vs. hepatitis C virus etiology was associated with a lower likelihood of consistent or inconsistent HCC surveillance receipt (adjusted odds ratio [aOR] 0.37; 95% CI 0.32-0.44) and detection of early-stage HCC (aOR 0.49; 95% CI 0.40-0.60) and worse overall survival (adjusted hazard ratio 1.20; 95% CI 1.09-1.32).
Study details: This was a population-based cohort study of US Medicare beneficiaries including 5098 patients aged ≥68 years with HCC, which was attributable to NAFLD in most patients (35.6%).
Disclosures: The study was funded by the American College of Gastroenterology, US Department of Defense, and US National Institute of Health. Some authors reported being consultants, advisory board members, or shareholders of and receiving research grants from various organizations.
Source: Karim MA et al. Clinical characteristics and outcomes of nonalcoholic fatty liver disease–associated hepatocellular carcinoma in the United States. Clin Gastroenterol Hepatol. 2022 (Mar 17). Doi: 10.1016/j.cgh.2022.03.010
Key clinical point: Compared with other liver disease etiologies, nonalcoholic fatty liver disease (NAFLD) was associated with lower hepatocellular carcinoma (HCC) surveillance receipt and early-stage detection, thus calling for interventions for increased surveillance implementation and improved prognosis of patients with NAFLD-related HCC.
Major finding: NAFLD vs. hepatitis C virus etiology was associated with a lower likelihood of consistent or inconsistent HCC surveillance receipt (adjusted odds ratio [aOR] 0.37; 95% CI 0.32-0.44) and detection of early-stage HCC (aOR 0.49; 95% CI 0.40-0.60) and worse overall survival (adjusted hazard ratio 1.20; 95% CI 1.09-1.32).
Study details: This was a population-based cohort study of US Medicare beneficiaries including 5098 patients aged ≥68 years with HCC, which was attributable to NAFLD in most patients (35.6%).
Disclosures: The study was funded by the American College of Gastroenterology, US Department of Defense, and US National Institute of Health. Some authors reported being consultants, advisory board members, or shareholders of and receiving research grants from various organizations.
Source: Karim MA et al. Clinical characteristics and outcomes of nonalcoholic fatty liver disease–associated hepatocellular carcinoma in the United States. Clin Gastroenterol Hepatol. 2022 (Mar 17). Doi: 10.1016/j.cgh.2022.03.010
Key clinical point: Compared with other liver disease etiologies, nonalcoholic fatty liver disease (NAFLD) was associated with lower hepatocellular carcinoma (HCC) surveillance receipt and early-stage detection, thus calling for interventions for increased surveillance implementation and improved prognosis of patients with NAFLD-related HCC.
Major finding: NAFLD vs. hepatitis C virus etiology was associated with a lower likelihood of consistent or inconsistent HCC surveillance receipt (adjusted odds ratio [aOR] 0.37; 95% CI 0.32-0.44) and detection of early-stage HCC (aOR 0.49; 95% CI 0.40-0.60) and worse overall survival (adjusted hazard ratio 1.20; 95% CI 1.09-1.32).
Study details: This was a population-based cohort study of US Medicare beneficiaries including 5098 patients aged ≥68 years with HCC, which was attributable to NAFLD in most patients (35.6%).
Disclosures: The study was funded by the American College of Gastroenterology, US Department of Defense, and US National Institute of Health. Some authors reported being consultants, advisory board members, or shareholders of and receiving research grants from various organizations.
Source: Karim MA et al. Clinical characteristics and outcomes of nonalcoholic fatty liver disease–associated hepatocellular carcinoma in the United States. Clin Gastroenterol Hepatol. 2022 (Mar 17). Doi: 10.1016/j.cgh.2022.03.010
On-treatment HCC risk is inversely related to baseline viral load in HBeAg-positive chronic hepatitis B
Key clinical point: In hepatitis B e-antigen (HBeAg)-positive, non-cirrhotic, adult patients with chronic hepatitis B (CHB) and baseline hepatitis B virus (HBV) DNA levels of ≥5.00 log10 IU/mL, pretreatment baseline serum HBV DNA levels were inversely associated with the on-treatment risk for hepatocellular carcinoma (HCC).
Major finding: Relative to that at HBV DNA levels of ≥8.00 log10 IU/mL, HCC risk increased incrementally with a decrease in baseline HBV DNA levels, with the adjusted hazard ratios for 7.00-7.99, 6.00-6.99, and 5.00-5.99 log10 IU/mL of HBV DNA being 2.48 (P = .03), 3.69 (P = .002), and 6.10 (P < .001), respectively.
Study details: The findings are from a multicenter cohort study involving 2073 HBeAg-positive, non-cirrhotic, treatment-naive, adult patients with CHB who had baseline HBV DNA levels of ≥5.00 log10 IU/mL and had initiated treatment with entecavir or tenofovir disoproxil fumarate.
Disclosures: The study was sponsored by the Ministry of Health & Welfare, Republic of Korea. Y-S Lim declared being an advisory board member of and receiving research funds from Gilead Sciences.
Source: Choi W-M et al. Increasing on-treatment hepatocellular carcinoma risk with decreasing baseline viral load in HBeAg-positive chronic hepatitis B. J Clin Invest. 2022 (Mar 31). Doi: 10.1172/JCI154833
Key clinical point: In hepatitis B e-antigen (HBeAg)-positive, non-cirrhotic, adult patients with chronic hepatitis B (CHB) and baseline hepatitis B virus (HBV) DNA levels of ≥5.00 log10 IU/mL, pretreatment baseline serum HBV DNA levels were inversely associated with the on-treatment risk for hepatocellular carcinoma (HCC).
Major finding: Relative to that at HBV DNA levels of ≥8.00 log10 IU/mL, HCC risk increased incrementally with a decrease in baseline HBV DNA levels, with the adjusted hazard ratios for 7.00-7.99, 6.00-6.99, and 5.00-5.99 log10 IU/mL of HBV DNA being 2.48 (P = .03), 3.69 (P = .002), and 6.10 (P < .001), respectively.
Study details: The findings are from a multicenter cohort study involving 2073 HBeAg-positive, non-cirrhotic, treatment-naive, adult patients with CHB who had baseline HBV DNA levels of ≥5.00 log10 IU/mL and had initiated treatment with entecavir or tenofovir disoproxil fumarate.
Disclosures: The study was sponsored by the Ministry of Health & Welfare, Republic of Korea. Y-S Lim declared being an advisory board member of and receiving research funds from Gilead Sciences.
Source: Choi W-M et al. Increasing on-treatment hepatocellular carcinoma risk with decreasing baseline viral load in HBeAg-positive chronic hepatitis B. J Clin Invest. 2022 (Mar 31). Doi: 10.1172/JCI154833
Key clinical point: In hepatitis B e-antigen (HBeAg)-positive, non-cirrhotic, adult patients with chronic hepatitis B (CHB) and baseline hepatitis B virus (HBV) DNA levels of ≥5.00 log10 IU/mL, pretreatment baseline serum HBV DNA levels were inversely associated with the on-treatment risk for hepatocellular carcinoma (HCC).
Major finding: Relative to that at HBV DNA levels of ≥8.00 log10 IU/mL, HCC risk increased incrementally with a decrease in baseline HBV DNA levels, with the adjusted hazard ratios for 7.00-7.99, 6.00-6.99, and 5.00-5.99 log10 IU/mL of HBV DNA being 2.48 (P = .03), 3.69 (P = .002), and 6.10 (P < .001), respectively.
Study details: The findings are from a multicenter cohort study involving 2073 HBeAg-positive, non-cirrhotic, treatment-naive, adult patients with CHB who had baseline HBV DNA levels of ≥5.00 log10 IU/mL and had initiated treatment with entecavir or tenofovir disoproxil fumarate.
Disclosures: The study was sponsored by the Ministry of Health & Welfare, Republic of Korea. Y-S Lim declared being an advisory board member of and receiving research funds from Gilead Sciences.
Source: Choi W-M et al. Increasing on-treatment hepatocellular carcinoma risk with decreasing baseline viral load in HBeAg-positive chronic hepatitis B. J Clin Invest. 2022 (Mar 31). Doi: 10.1172/JCI154833
Aspirin use may be protective against HCC in chronic hepatitis B
Key clinical point: Long-term aspirin use may reduce the risk for hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV) infection.
Major finding: After adjusting for confounding factors, aspirin use was associated with a decreased likelihood of HCC in the entire population (adjusted hazard ratio [aHR] 0.84; P = .002) and in the matched cohort (aHR 0.87; P = .01).
Study details: The data come from a cohort study including 161,673 patients aged ≥40 years with chronic HBV infection and no history of HCC, of which 9837 patients were aspirin users (for ≥3 years). A 1:4 propensity score matching yielded 9837 matched pairs of users and nonusers.
Disclosures: The study was sponsored by the Korea Health Industry Development Institute through “Social and Environmental Risk Research” funded by the Ministry of Health & Welfare. The authors declared no conflicts of interest.
Source: Yun B et al. Clinical indication of aspirin associated with reduced risk of liver cancer in chronic hepatitis B: A nationwide cohort study. Am J Gastroenterol. 2022 (Mar 14). Doi: 10.14309/ajg.0000000000001725
Key clinical point: Long-term aspirin use may reduce the risk for hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV) infection.
Major finding: After adjusting for confounding factors, aspirin use was associated with a decreased likelihood of HCC in the entire population (adjusted hazard ratio [aHR] 0.84; P = .002) and in the matched cohort (aHR 0.87; P = .01).
Study details: The data come from a cohort study including 161,673 patients aged ≥40 years with chronic HBV infection and no history of HCC, of which 9837 patients were aspirin users (for ≥3 years). A 1:4 propensity score matching yielded 9837 matched pairs of users and nonusers.
Disclosures: The study was sponsored by the Korea Health Industry Development Institute through “Social and Environmental Risk Research” funded by the Ministry of Health & Welfare. The authors declared no conflicts of interest.
Source: Yun B et al. Clinical indication of aspirin associated with reduced risk of liver cancer in chronic hepatitis B: A nationwide cohort study. Am J Gastroenterol. 2022 (Mar 14). Doi: 10.14309/ajg.0000000000001725
Key clinical point: Long-term aspirin use may reduce the risk for hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV) infection.
Major finding: After adjusting for confounding factors, aspirin use was associated with a decreased likelihood of HCC in the entire population (adjusted hazard ratio [aHR] 0.84; P = .002) and in the matched cohort (aHR 0.87; P = .01).
Study details: The data come from a cohort study including 161,673 patients aged ≥40 years with chronic HBV infection and no history of HCC, of which 9837 patients were aspirin users (for ≥3 years). A 1:4 propensity score matching yielded 9837 matched pairs of users and nonusers.
Disclosures: The study was sponsored by the Korea Health Industry Development Institute through “Social and Environmental Risk Research” funded by the Ministry of Health & Welfare. The authors declared no conflicts of interest.
Source: Yun B et al. Clinical indication of aspirin associated with reduced risk of liver cancer in chronic hepatitis B: A nationwide cohort study. Am J Gastroenterol. 2022 (Mar 14). Doi: 10.14309/ajg.0000000000001725
A hormone therapy shows favorable treatment satisfaction in menopausal women with MS
Key clinical point: Hormone therapy with Duavee®, containing conjugated estrogens (0.45 mg) and bazedoxifene (20 mg), yielded a favorable study retention and treatment satisfaction in menopausal women with multiple sclerosis (MS).
Major finding: Patients receiving Duavee® vs. placebo had a fewer missed doses (median, interquartile range [IQR] 0 [0-0] vs. 1 [0-9]), a greater Global Satisfaction on the Treatment Satisfaction Questionnaire for Medication (median, IQR 65.9 [52.8-100] vs. 62.5 [11.1-93.0]), and lesser side effects (20% vs. 13%), with none of the patients reporting a clinical relapse.
Study details: Findings are from a double-blind phase 1b/2a trial involving 21 peri/postmenopausal women with MS who were randomly assigned to parallel groups of Duavee® or equivalent placebo for 8 weeks.
Disclosures: This study was funded the National Multiple Sclerosis Society pilot grant and CTSI grant. Some authors declared receiving research support, personal compensation, speaker fees, or nonfinancial support from various sources, including Wyeth/Pfizer, the manufacturer of Duavee®. Several authors are provisional patent holders for the use of bazedoxifene in remyelination therapy.
Source: Bove R et al. A hormonal therapy for menopausal women with MS: A phase Ib/IIa randomized controlled trial. Mult Scler Relat Disord. 2022;67:103747 (Mar 19). Doi: 10.1016/j.msard.2022.103747
Key clinical point: Hormone therapy with Duavee®, containing conjugated estrogens (0.45 mg) and bazedoxifene (20 mg), yielded a favorable study retention and treatment satisfaction in menopausal women with multiple sclerosis (MS).
Major finding: Patients receiving Duavee® vs. placebo had a fewer missed doses (median, interquartile range [IQR] 0 [0-0] vs. 1 [0-9]), a greater Global Satisfaction on the Treatment Satisfaction Questionnaire for Medication (median, IQR 65.9 [52.8-100] vs. 62.5 [11.1-93.0]), and lesser side effects (20% vs. 13%), with none of the patients reporting a clinical relapse.
Study details: Findings are from a double-blind phase 1b/2a trial involving 21 peri/postmenopausal women with MS who were randomly assigned to parallel groups of Duavee® or equivalent placebo for 8 weeks.
Disclosures: This study was funded the National Multiple Sclerosis Society pilot grant and CTSI grant. Some authors declared receiving research support, personal compensation, speaker fees, or nonfinancial support from various sources, including Wyeth/Pfizer, the manufacturer of Duavee®. Several authors are provisional patent holders for the use of bazedoxifene in remyelination therapy.
Source: Bove R et al. A hormonal therapy for menopausal women with MS: A phase Ib/IIa randomized controlled trial. Mult Scler Relat Disord. 2022;67:103747 (Mar 19). Doi: 10.1016/j.msard.2022.103747
Key clinical point: Hormone therapy with Duavee®, containing conjugated estrogens (0.45 mg) and bazedoxifene (20 mg), yielded a favorable study retention and treatment satisfaction in menopausal women with multiple sclerosis (MS).
Major finding: Patients receiving Duavee® vs. placebo had a fewer missed doses (median, interquartile range [IQR] 0 [0-0] vs. 1 [0-9]), a greater Global Satisfaction on the Treatment Satisfaction Questionnaire for Medication (median, IQR 65.9 [52.8-100] vs. 62.5 [11.1-93.0]), and lesser side effects (20% vs. 13%), with none of the patients reporting a clinical relapse.
Study details: Findings are from a double-blind phase 1b/2a trial involving 21 peri/postmenopausal women with MS who were randomly assigned to parallel groups of Duavee® or equivalent placebo for 8 weeks.
Disclosures: This study was funded the National Multiple Sclerosis Society pilot grant and CTSI grant. Some authors declared receiving research support, personal compensation, speaker fees, or nonfinancial support from various sources, including Wyeth/Pfizer, the manufacturer of Duavee®. Several authors are provisional patent holders for the use of bazedoxifene in remyelination therapy.
Source: Bove R et al. A hormonal therapy for menopausal women with MS: A phase Ib/IIa randomized controlled trial. Mult Scler Relat Disord. 2022;67:103747 (Mar 19). Doi: 10.1016/j.msard.2022.103747
Pregnancy and the risk of developing multiple sclerosis: Is there a link?
Key clinical point: Pregnancy may have a protective effect on the risk of developing multiple sclerosis (MS) in addition to a hypothesized reverse causality.
Major finding: Women with MS vs. women without any autoimmune disease were less likely to record the 18 pregnancy-related gynecological International Classification of Diseases 10th Revision codes, with strongest negative correlation observed for the supervision of normal pregnancy (adjusted P = 9.12 × 10−27) and high-risk pregnancy (adjusted P = 2.49 × 10−12).
Study details: Findings are from a retrospective case-control study including women with newly diagnosed MS (n = 5720) and three control cohorts of women with newly diagnosed Crohn’s Disease (n = 6280), psoriasis (n = 26,729), and women without any of the three autoimmune diseases (n = 40,555).
Disclosures: The study was funded by European Union’s Horizon 2020 Research and Innovation Program, Hertie Foundation, and the Hans and Klementia Langmatz Stiftung, among others. B Hemmer declared serving on scientific advisory boards and receiving speaker honoraria and research funding from various sources. The other authors declared no conflicts of interest.
Citation: Gasperi C et al. Association of pregnancies with risk of multiple sclerosis. Mult Scler. 2022 (Mar 18). Doi: 10.1177/13524585221080542
Key clinical point: Pregnancy may have a protective effect on the risk of developing multiple sclerosis (MS) in addition to a hypothesized reverse causality.
Major finding: Women with MS vs. women without any autoimmune disease were less likely to record the 18 pregnancy-related gynecological International Classification of Diseases 10th Revision codes, with strongest negative correlation observed for the supervision of normal pregnancy (adjusted P = 9.12 × 10−27) and high-risk pregnancy (adjusted P = 2.49 × 10−12).
Study details: Findings are from a retrospective case-control study including women with newly diagnosed MS (n = 5720) and three control cohorts of women with newly diagnosed Crohn’s Disease (n = 6280), psoriasis (n = 26,729), and women without any of the three autoimmune diseases (n = 40,555).
Disclosures: The study was funded by European Union’s Horizon 2020 Research and Innovation Program, Hertie Foundation, and the Hans and Klementia Langmatz Stiftung, among others. B Hemmer declared serving on scientific advisory boards and receiving speaker honoraria and research funding from various sources. The other authors declared no conflicts of interest.
Citation: Gasperi C et al. Association of pregnancies with risk of multiple sclerosis. Mult Scler. 2022 (Mar 18). Doi: 10.1177/13524585221080542
Key clinical point: Pregnancy may have a protective effect on the risk of developing multiple sclerosis (MS) in addition to a hypothesized reverse causality.
Major finding: Women with MS vs. women without any autoimmune disease were less likely to record the 18 pregnancy-related gynecological International Classification of Diseases 10th Revision codes, with strongest negative correlation observed for the supervision of normal pregnancy (adjusted P = 9.12 × 10−27) and high-risk pregnancy (adjusted P = 2.49 × 10−12).
Study details: Findings are from a retrospective case-control study including women with newly diagnosed MS (n = 5720) and three control cohorts of women with newly diagnosed Crohn’s Disease (n = 6280), psoriasis (n = 26,729), and women without any of the three autoimmune diseases (n = 40,555).
Disclosures: The study was funded by European Union’s Horizon 2020 Research and Innovation Program, Hertie Foundation, and the Hans and Klementia Langmatz Stiftung, among others. B Hemmer declared serving on scientific advisory boards and receiving speaker honoraria and research funding from various sources. The other authors declared no conflicts of interest.
Citation: Gasperi C et al. Association of pregnancies with risk of multiple sclerosis. Mult Scler. 2022 (Mar 18). Doi: 10.1177/13524585221080542
Patients with multiple sclerosis at an increased risk for cardiovascular diseases
Key clinical point: Genetic liability to multiple sclerosis (MS) was associated with an increased risk for coronary artery disease (CAD), myocardial infarction (MI), heart failure (HF), all-cause stroke (AS), and any ischemic stroke (AIS), but not atrial fibrillation (AF) or other stroke subtypes.
Major finding: Genetic liability to MS was associated with an increased risk for CAD (odds ratio [OR] 1.02; P = .03), MI (OR 1.03; P = .01), HF (OR 1.02; P = .02), AS (OR 1.02; P = .02), and AIS (OR 1.02; P = .04), but not with AF or other stroke subtypes.
Study details: This was a two-sample Mendelian randomization analysis of genetic summary data for 47,429 MS (68,374 healthy controls [HC]), 60,801 CAD (123,504 HC), and 43,676 MI (128,199 HC), 60,620 AF (970,216 HC), and 47,309 HF (930,014 HC) cases from large-scale genome-wide association studies.
Disclosures: The study was supported by grants from Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang, China, the Major Project of Science and Technology Innovation 2025 in Ningbo, and others. The authors declared no conflicts of interest.
Source: Yang F et al. Multiple sclerosis and the risk of cardiovascular diseases: A Mendelian randomization study. Front Immunol. 2022;13:861885 (Mar 15). Doi: 10.3389/fimmu.2022.861885
Key clinical point: Genetic liability to multiple sclerosis (MS) was associated with an increased risk for coronary artery disease (CAD), myocardial infarction (MI), heart failure (HF), all-cause stroke (AS), and any ischemic stroke (AIS), but not atrial fibrillation (AF) or other stroke subtypes.
Major finding: Genetic liability to MS was associated with an increased risk for CAD (odds ratio [OR] 1.02; P = .03), MI (OR 1.03; P = .01), HF (OR 1.02; P = .02), AS (OR 1.02; P = .02), and AIS (OR 1.02; P = .04), but not with AF or other stroke subtypes.
Study details: This was a two-sample Mendelian randomization analysis of genetic summary data for 47,429 MS (68,374 healthy controls [HC]), 60,801 CAD (123,504 HC), and 43,676 MI (128,199 HC), 60,620 AF (970,216 HC), and 47,309 HF (930,014 HC) cases from large-scale genome-wide association studies.
Disclosures: The study was supported by grants from Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang, China, the Major Project of Science and Technology Innovation 2025 in Ningbo, and others. The authors declared no conflicts of interest.
Source: Yang F et al. Multiple sclerosis and the risk of cardiovascular diseases: A Mendelian randomization study. Front Immunol. 2022;13:861885 (Mar 15). Doi: 10.3389/fimmu.2022.861885
Key clinical point: Genetic liability to multiple sclerosis (MS) was associated with an increased risk for coronary artery disease (CAD), myocardial infarction (MI), heart failure (HF), all-cause stroke (AS), and any ischemic stroke (AIS), but not atrial fibrillation (AF) or other stroke subtypes.
Major finding: Genetic liability to MS was associated with an increased risk for CAD (odds ratio [OR] 1.02; P = .03), MI (OR 1.03; P = .01), HF (OR 1.02; P = .02), AS (OR 1.02; P = .02), and AIS (OR 1.02; P = .04), but not with AF or other stroke subtypes.
Study details: This was a two-sample Mendelian randomization analysis of genetic summary data for 47,429 MS (68,374 healthy controls [HC]), 60,801 CAD (123,504 HC), and 43,676 MI (128,199 HC), 60,620 AF (970,216 HC), and 47,309 HF (930,014 HC) cases from large-scale genome-wide association studies.
Disclosures: The study was supported by grants from Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang, China, the Major Project of Science and Technology Innovation 2025 in Ningbo, and others. The authors declared no conflicts of interest.
Source: Yang F et al. Multiple sclerosis and the risk of cardiovascular diseases: A Mendelian randomization study. Front Immunol. 2022;13:861885 (Mar 15). Doi: 10.3389/fimmu.2022.861885