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Meta-Analysis
. 2016 Mar 23;17(1):1470320316628717.
doi: 10.1177/1470320316628717. Print 2016 Jan-Mar.

Therapeutic effect of renin angiotensin system inhibitors on liver fibrosis

Qianqian Zhu  1 , Na Li  1 , Fang Li  1 , Zhihua Zhou  1 , Qunying Han  1 , Yi Lv  2 , Jiao Sang  1 , Zhengwen Liu  3
Affiliations
Meta-Analysis

Therapeutic effect of renin angiotensin system inhibitors on liver fibrosis

Qianqian Zhu et al. J Renin Angiotensin Aldosterone Syst. .

Abstract

Background and objective: Currently, there is no effective therapy available for liver fibrosis. This study aims to evaluate the efficacy of renin angiotensin system inhibitors on liver fibrosis.

Method: Full-text randomized controlled trials in patients with liver fibrosis were identified and included in the meta-analysis. The primary outcome measure was the histological fibrosis score of the liver. Secondary outcome measures included fibrosis area of the liver, serological levels of fibrosis markers, adverse events, and withdrawals.

Results: From 6973 non-duplicated entries by systematic search, four randomized controlled trials with 210 patients were identified. The renin angiotensin system inhibitors therapy resulted in a marginally significant reduction in liver fibrosis score (MD = -0.30; 95% CI: -0.62-0.02, p = 0.05) and a significant reduction in liver fibrosis area (MD = -2.36%; 95% CI: -4.22%--0.50%, p = 0.01) as compared with control. The therapy was well tolerated and there was no significant difference in withdrawals between treatment and control groups (RD = 0.00; 95% CI: -0.06-0.06, p = 0.97).

Conclusions: Renin angiotensin system inhibitor therapy results in a reduction in liver fibrosis score and liver fibrosis area in patients with hepatic fibrosis with good safety profile. However, randomized controlled trials of high-quality will clarify the effectiveness of renin angiotensin system inhibitors on liver fibrosis.

Keywords: Angiotensin-converting-enzyme inhibitors; angiotensin receptor blocker; liver fibrosis; treatment.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flowchart showing the process of literature searching and selection.
Figure 2.
Figure 2.
Meta-analysis of fibrosis score of the liver in angiotensin receptor blockers treatment and control patients.
Figure 3.
Figure 3.
Meta-analysis of fibrosis area of the liver in angiotensin receptor blockers treatment and control patients.
Figure 4.
Figure 4.
Meta-analysis of fibrosis markers (serological levels of transforming growth factor beta 1 (TGF-β1)) in angiotensin receptor blockers treatment and control patients.
See this image and copyright information in PMC

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