Key result
ACEI and ARB therapy was associated with a significantly reduced risk of developing hepatocellular carcinoma (RR 0.704; 95% CI 0.526-0.944; p=0.019).
Why the study?
Data remain controversial regarding whether ACEI or ARB therapy influences cancer development or enhances hepatocellular carcinoma development and clinical outcomes.
Does ACEI/ARB therapy reduce the development of hepatocellular carcinoma?
Meta-Analysis
Does ACEI/ARB therapy reduce the development of hepatocellular carcinoma?
Relative Risk: 0.704 (95% CI 0.526–0.944)
p-value: p=0.019
ACEI and ARB therapy, particularly ARBs, may reduce the risk of developing hepatocellular carcinoma.
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 the 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.
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Asgharzadeh et al. (2020) conducted a meta-analysis in Hepatocellular carcinoma. ACEI and ARB therapy was evaluated on Development of hepatocellular carcinoma (RR 0.704, 95% CI 0.526-0.944, p=0.019). ACEI and ARB therapy was associated with a significantly reduced risk of developing hepatocellular carcinoma (RR 0.704; 95% CI 0.526-0.944; p=0.019).
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