Implications of anaemia and response to anaemia treatment on outcomes in patients with cirrhosis.
ACLF, acute-on-chronic liver failure
AIH, autoimmune hepatitis
ALT, alanine aminotransferase
AP, alkaline phosphatase
AST, aspartate aminotransferase
CRP, C-reactive protein
Haemoglobin
INR, international normalised ratio
Iron deficiency
Iron supplementation
LT, liver transplantation
Liver transplantation
MELD, model for end-stage liver disease
NASH, non-alcoholic steatohepatitis
NSBBs, non-selective beta blockers
PBC, primary biliary cholangitis
PSC, primary sclerosing cholangitis
Rifaximin
SSC, secondary sclerosing cholangitis
TIPS, transjugular intrahepatic portosystemic shunt
aPTT, activated partial thromboplastin time
ΔHb3, difference of haemoglobin levels after 3 months
ΔHb6, difference of haemoglobin levels after 6 months
Journal
JHEP reports : innovation in hepatology
ISSN: 2589-5559
Titre abrégé: JHEP Rep
Pays: Netherlands
ID NLM: 101761237
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
received:
03
08
2022
revised:
29
12
2022
accepted:
12
01
2023
entrez:
17
3
2023
pubmed:
18
3
2023
medline:
18
3
2023
Statut:
epublish
Résumé
Anaemia is frequently observed in patients with cirrhosis and was identified as a predictor of adverse outcomes, such as increased mortality and occurrence of acute-on-chronic liver failure. To date, the possible effects of iron supplementation on these adverse outcomes are not well described. We therefore aimed to assess the role of iron supplementation in patients with cirrhosis and its capability to improve prognosis. Laboratory diagnostics were performed in consecutive outpatients with cirrhosis admitted between July 2018 and December 2019 to the University Hospital Essen. Associations with transplant-free survival were assessed in regression models. A total of 317 outpatients with cirrhosis were included, of whom 61 received a liver transplant (n = 19) or died (n = 42). In multivariate Cox regression analysis, male sex (hazard ratio [HR] = 3.33, 95% CI [1.59, 6.99], An increase of haemoglobin levels is associated with improvement of transplant-free survival in patients with cirrhosis. Because the prediction of haemoglobin increase significantly depends on rifaximin and iron supplementation, application of these two medications can have an important impact on the outcome of these patients. Anaemia is very common in patients with cirrhosis and is known to be a predictor of negative outcomes, but little is known about the effect of iron substitution in these individuals. In our cohort, increase of haemoglobin levels improved transplant-free survival of patients with cirrhosis. The increase of haemoglobin levels was mainly induced by iron supplementation and was even stronger in the case of concomitant use of iron and rifaximin. UME-ID-10042.
Sections du résumé
Background & Aims
UNASSIGNED
Anaemia is frequently observed in patients with cirrhosis and was identified as a predictor of adverse outcomes, such as increased mortality and occurrence of acute-on-chronic liver failure. To date, the possible effects of iron supplementation on these adverse outcomes are not well described. We therefore aimed to assess the role of iron supplementation in patients with cirrhosis and its capability to improve prognosis.
Methods
UNASSIGNED
Laboratory diagnostics were performed in consecutive outpatients with cirrhosis admitted between July 2018 and December 2019 to the University Hospital Essen. Associations with transplant-free survival were assessed in regression models.
Results
UNASSIGNED
A total of 317 outpatients with cirrhosis were included, of whom 61 received a liver transplant (n = 19) or died (n = 42). In multivariate Cox regression analysis, male sex (hazard ratio [HR] = 3.33, 95% CI [1.59, 6.99],
Conclusions
UNASSIGNED
An increase of haemoglobin levels is associated with improvement of transplant-free survival in patients with cirrhosis. Because the prediction of haemoglobin increase significantly depends on rifaximin and iron supplementation, application of these two medications can have an important impact on the outcome of these patients.
Impact and implications
UNASSIGNED
Anaemia is very common in patients with cirrhosis and is known to be a predictor of negative outcomes, but little is known about the effect of iron substitution in these individuals. In our cohort, increase of haemoglobin levels improved transplant-free survival of patients with cirrhosis. The increase of haemoglobin levels was mainly induced by iron supplementation and was even stronger in the case of concomitant use of iron and rifaximin.
Clinical trial registration
UNASSIGNED
UME-ID-10042.
Identifiants
pubmed: 36926273
doi: 10.1016/j.jhepr.2023.100688
pii: S2589-5559(23)00019-8
pmc: PMC10011825
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100688Informations de copyright
© 2023 The Author(s).
Déclaration de conflit d'intérêts
JRA: Speaker fees from AbbVie, travel support from Gilead, all unrelated to the submitted work. CML: Speaker and consulting fees from AbbVie, Gilead, MSD, Norgine, Falk, Eisai, Roche, Behring, and travel support from AbbVie and Gilead, all unrelated to the submitted work. Please refer to the accompanying ICMJE disclosure forms for further details.
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