Cirrhosis update: 5 reports on improving patient care

Cirrhosis, or late stage fibrosis, can result from a variety of causes including progression from nonalcoholic fatty liver disease and very often from alcohol-related liver disease. Without care from a physician, this can lead to end-stage liver disease and organ failure.

Healio Gastroenterology and Liver Disease presents the following reports on recently published studies on cirrhosis, including treatment with albumin to reduce systemic inflammation, cirrhosis care quality, rising rates of alcohol-related cirrhosis in North American men, and alterations in the skin microbiome.

High-dose albumin reduces systemic inflammation in cirrhosis

Treatment with high-dose levels of albumin reduced systemic inflammation and cardiocirculatory dysfunction in patients with decompensated cirrhosis, according to an analysis published in Gastroenterology.

“Recent investigations have suggested that systemic inflammation plays a major role in the pathogenesis of acute decompensation and [acute-on-chronic liver failure] in cirrhosis,” Javier Fernández, MD, PhD, from the Hospital Clinic of Barcelona in Spain, and colleagues wrote. “The current study allowed us to uncover important findings related to the efficacy of albumin treatment in cirrhosis. The most outstanding were that high doses of albumin, but not low doses of albumin, in patients with decompensated cirrhosis have significant immunomodulatory effects.” Read more

Advanced practice providers make difference in cirrhosis care quality

Patients with cirrhosis had improved quality of care and outcomes when treated by advanced practice providers compared with those without such care.

In the study published in Hepatology, Elliot B. Tapper, MD, from the University of Michigan, and colleagues retrospectively analyzed a “complication of process measures” including rates of hepatocellular carcinoma, hepatic encephalopathy, readmissions, and survival. Read more

Prevalence of alcoholic cirrhosis rising in North American men

Researchers reported an increasing prevalence of alcoholic cirrhosis in a large representative Canadian population, especially among middle-aged men, according to a presentation at the International Liver Congress 2019.

“Over the last two decades, efforts to increase awareness of heavy drinking and improve access to care for alcoholic cirrhosis patients have been implemented,” Hassan Azhari, MD, from the University of Calgary in Canada, said during his presentation. “However, the impact of these efforts has not been fully evaluated. We undertook this study to describe the epidemiology of alcoholic cirrhosis in a large North American cohort.” Read more

Advanced liver cancer therapy meets overall survival in cirrhosis subgroup

Can-Fite BioPharma announced that the phase 2 study of their advanced liver cancer candidate, Namodenoson, did not achieve its primary endpoint of overall survival, according to a press release.

However, investigators noted a superiority in overall survival among a subpopulation of patients with Child-Pugh B cirrhosis and secondary endpoints. Read more

Skin microbiome altered in patients with cirrhosis, increasing itching

Researchers identified alterations in the skin microbiome of patients with cirrhosis that correlated with itching intensity and itch modulators, according to a recently published study.

“In cirrhosis there is evidence of a global mucosal-immune impairment illustrated by altered systemic immune activation, neutrophil dysfunction and changes in microbial composition,” Jasmohan S. Bajaj, MD, from the Virginia Commonwealth University, and colleagues wrote. “These microbial alterations span the stool, intestinal mucosa, ascites fluid, serum and the oral cavity. The study results demonstrate alterations in the skin microbial composition across the body in cirrhosis compared to healthy controls.” Read more