VIDEO: Women with NASH-cirrhosis at higher risk for polypharmacy to manage chronic pain
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WASHINGTON — In a Healio video exclusive, Leen Al-Sayyed, MD, gastroenterology and transplant hepatology fellow at St. Louis University, reported women with nonalcoholic steatohepatitis-cirrhosis had an increased prevalence for polypharmacy.
Specifically, in the real-world, longitudinal observational cohort from the TARGET-NASH study, Al-Sayyed and colleagues found 75% of patients were treated with more than five medication and 37% were prescribed 10 or more medications (69% women) with the median number of medications used higher among women compared with men (9 vs. 7).
“Patients with NASH-cirrhosis are most affected by polypharmacy, and more so the female cirrhotics and we need to find out why,” Al-Sayyed said. “As liver disease severity increased, so did the likelihood of having at least one non-liver-related morbidity.”
Further, increased liver disease severity correlated with the likelihood of comorbid diseases; the likelihood of chronic pain also increased and occurred among almost 50% of patients with cirrhosis treated with benzodiazepines (22%), opioids (36%), NSAIDs (50%) and proton pump inhibitors (67%).
“We are trying to treat chronic pain, which is a very common comorbidity among these patients, but these medications can be a reason for liver decompensation for patients with cirrhosis,” Al-Sayyed said. “It’s really time to find the balance between treating the comorbidities of liver cirrhotic patients, weighing the risks vs. benefits and finding a way to balance that against therapeutic efficacy of those medications.”
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Al-Sayyed L, et al. The role of disease severity and gender in polypharmacy among patients with NAFLD enrolled in TARGET-NASH. Presented at: The Liver Meeting; Nov. 4-8, 2022; Washington (hybrid).
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