Noninvasive markers of liver fibrosis: on-treatment changes of serum markers predict the outcome of antifibrotic therapy

Tanwar, Sudeep; Trembling, Paul M.; Hogan, Brian; Srivastava, Ankur; Parkes, Julie; Harris, Scott; Grant, Paul; Nastouli, Eleni; Ocker, Matthias; Wehr, K.; Herold, C.; Neureiter, Daniel; Schuppan, Detlef; Rosenberg, William

doi:10.1097/meg.0000000000000789

Cited by 11 publications

(5 citation statements)

References 26 publications

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“…Although rapid reductions in APRI values, FIB-4 values, and LSMs obtained using ARFI may mainly result from improvement in hepatic necroinflammation rather than fibrosis regression, temporal changes in the noninvasive index can be a predictor of fibrosis regression in patients with CHC who receive Peg-IFN-based therapy. Tanwar et al demonstrated that a change in the enhanced liver fibrosis test (hyaluronic acid, terminal peptide of procollagen III, and tissue inhibitor of matrix metaloproteinase-1) from baseline to 12 months after Peg-IFN-based therapy initiation, in combination with baseline histologic staging, could predict histologic fibrosis regression at 24 months after the therapy [31]. Nonetheless, the results of the present study suggest that noninvasive index values obtained during or soon after DAA therapy may not be predictive of the concomitant fibrosis stage, and an additional histology-based correlative study is required to establish optimal cutoffs for predicting fibrosis stages.…”

Section: Discussionmentioning

confidence: 99%

Rapid decline of noninvasive fibrosis index values in patients with hepatitis C receiving treatment with direct-acting antiviral agents

Hsu

Lai

et al. 2019

BMC Gastroenterol

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Background Studies on temporal changes in noninvasive fibrosis indices and liver stiffness measurement (LSM) in patients with chronic hepatitis C (CHC) treated with direct-acting antiviral agents (DAAs) are limited. Methods We retrospectively enrolled consecutive patients with CHC who had received DAAs. Results In total, we recruited 395 consecutive patients, of which 388 (98.2%) achieved a sustained virologic response (SVR) at 12 weeks after therapy. In patients who received DAA therapy and achieved SVR 12 weeks after therapy ( n = 388), the median aspartate aminotransferase/platelet ratio index (APRI) value decreased from 1.19 (0.62–2.44) at baseline to 0.50 (0.32–0.95), 0.51 (0.31–0.92), 0.48 (0.31–0.88), and 0.52 (0.33–0.92) at week 2, week 4, end of therapy, and PW12, respectively (all P < 0.001). The median FIB-4 value decreased from 2.88 (1.56–5.60) at baseline to 2.10 (1.30–3.65), 2.15 (1.30–3.65), 2.11 (1.37–3.76), and 2.22 (1.45–3.82) at week 2, week 4, end of therapy, and PW12, respectively (all P < 0.001). The median alanine aminotransferase level significantly decreased from week 2 until PW12 (all P < 0.001). The platelet count significantly increased from 2 weeks after DAA therapy initiation until PW12 (all P < 0.001); however, the magnitude of changes in the platelet count was low. In patients with paired LSMs obtained using acoustic radiation force impulse elastography at baseline and PW12 ( n = 199), the median LSM decreased from 1.78 (1.25–2.30) m/s at baseline to 1.38 (1.14–1.88) m/s at PW12 ( P < 0.001). Conclusions Noninvasive fibrosis indices, namely APRI and FIB-4, exhibited a rapid and sustained decline from week 2 until PW12 in patients with CHC who achieved SVR to DAA therapy. The rapid decline in APRI and FIB-4 values might mainly result from improvement in necroinflammation. Electronic supplementary material The online version of this article (10.1186/s12876-019-0973-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Rapid decline of noninvasive fibrosis index values in patients with hepatitis C receiving treatment with direct-acting antiviral agents

Hsu

Lai

et al. 2019

BMC Gastroenterol

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“…Collagen biomarkers may also be helpful to follow the efficiency of anti-fibrotic drugs. The N-terminal peptide of procollagen III associated with other ECM biomarkers, hyaluronic acid and tissue inhibitor of matrix metalloproteinase-1, is a predictor of the outcome of anti-fibrotic therapy in patients with chronic hepatitis C [360]. Markers of the ECM remodeling reflect the effect of anti-fibrotic therapy in a rat model of liver fibrosis induced by bile-duct ligation [359].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Molecular and tissue alterations of collagens in fibrosis

2018

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The collagen network is altered in fibrotic diseases associated with extracellular matrix (ECM) biosynthesis and remodeling. This mini-review focuses on the quantitative and qualitative modifications of collagens occurring at the molecular and tissue levels in fibrosis. They result from changes in collagen expression, biosynthesis, enzymatic cross-linking and degradation by several protease families. These molecular modifications, which are mostly regulated by TGF-β, are associated with altered collagen organization at the tissue level, leading to a fibrotic signature that can be analyzed by Second Harmonic Generation (SHG) microscopy.

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“…Trials on steatohepatitis, cirrhosis and different kinds of hepatitis ( n = 18) included patient cohorts ranging from 14 to 200 participants, all of them aged >18 years. Patients were treated with silymarin orally or intravenously ( Pares et al, 1998 ; Tanamly et al, 2004 ; Ferenci et al, 2008 ; Hawke et al, 2010 ; Fried et al, 2012 ; Adeyemo et al, 2013 ; Fathalah et al, 2017 ; Tanwar et al, 2017 ) with dosages ranging from 280 to 2,100 mg/day or 5–20 mg/kg/day, respectively. Six studies compared the HM group to a placebo group ( Pares et al, 1998 ; Tanamly et al, 2004 ; Hawke et al, 2010 ; Fried et al, 2012 ; Adeyemo et al, 2013 ; Tanwar et al, 2017 ).…”

Section: Resultsmentioning

confidence: 99%

“…Patients were treated with silymarin orally or intravenously ( Pares et al, 1998 ; Tanamly et al, 2004 ; Ferenci et al, 2008 ; Hawke et al, 2010 ; Fried et al, 2012 ; Adeyemo et al, 2013 ; Fathalah et al, 2017 ; Tanwar et al, 2017 ) with dosages ranging from 280 to 2,100 mg/day or 5–20 mg/kg/day, respectively. Six studies compared the HM group to a placebo group ( Pares et al, 1998 ; Tanamly et al, 2004 ; Hawke et al, 2010 ; Fried et al, 2012 ; Adeyemo et al, 2013 ; Tanwar et al, 2017 ). Silymarin did not reduce virus titers and/or serum alanine transaminase (ALT) in patients with Hepatitis C and non-alcoholic Steatohepatitis C, compared to placebo ( Adeyemo et al, 2013 ).…”

Section: Resultsmentioning

confidence: 99%

Current state of research on the clinical benefits of herbal medicines for non-life-threatening ailments

Salm,

Rutz,

van den Akker

et al. 2023

Front. Pharmacol.

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Herbal medicines are becoming increasingly popular among patients because they are well tolerated and do not exert severe side effects. Nevertheless, they receive little consideration in therapeutic settings. The present article reviews the current state of research on the clinical benefits of herbal medicines on five indication groups, psychosomatic disorders, gynecological complaints, gastrointestinal disorders, urinary and upper respiratory tract infections. The study search was based on the database PubMed and concentrated on herbal medicines legally approved in Europe. After applying defined inclusion and exclusion criteria, 141 articles were selected: 59 for psychosomatic disorders (100% randomized controlled trials; RCTs), 20 for gynecological complaints (56% RCTs), 19 for gastrointestinal disorders (68% RCTs), 16 for urinary tract infections (UTI, 63% RCTs) and 24 for upper respiratory tract infections (URTI) (79% RCTs). For the majority of the studies, therapeutic benefits were evaluated by patient reported outcome measures (PROs). For psychosomatic disorders, gynecological complaints and URTI more than 80% of the study outcomes were positive, whereas the clinical benefit of herbal medicines for the treatment of UTI and gastrointestinal disorders was lower with 55%. The critical appraisal of the articles shows that there is a lack of high-quality studies and, with regard to gastrointestinal disorders, the clinical benefits of herbal medicines as a stand-alone form of therapy are unclear. According to the current state of knowledge, scientific evidence has still to be improved to allow integration of herbal medicines into guidelines and standard treatment regimens for the indications reviewed here. In addition to clinical data, real world data and outcome measures can add significant value to pave the way for herbal medicines into future therapeutic applications.

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Noninvasive markers of liver fibrosis: on-treatment changes of serum markers predict the outcome of antifibrotic therapy

Cited by 11 publications

References 26 publications

Rapid decline of noninvasive fibrosis index values in patients with hepatitis C receiving treatment with direct-acting antiviral agents

Rapid decline of noninvasive fibrosis index values in patients with hepatitis C receiving treatment with direct-acting antiviral agents

Molecular and tissue alterations of collagens in fibrosis

Current state of research on the clinical benefits of herbal medicines for non-life-threatening ailments

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