Amiodarone and risk of liver cirrhosis: a nationwide, population-based study

Liver cirrhosis is an uncommon but not rare side effect of amiodarone-induced hepatotoxicity. Patients with hepatitis B virus and hepatitis C virus infections are at a high risk for developing liver cirrhosis. However, the relationship between this treatment and risk of liver cirrhosis in high-risk...

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Bibliographic Details
Published in:Therapeutics and clinical risk management 2019-01, Vol.15, p.103-112
Main Authors: Huang, Ching-Hui, Lai, Ya-Yun, Kuo, Yu-Jui, Yang, Su-Ching, Chang, Yu-Jun, Chang, Kuo-Kuan, Chen, Wen-Kang
Format: Article
Language:English
Subjects:
Adefovir dipivoxil
Amiodarone
Community colleges
Comorbidity
Drug dosages
Health care
Health insurance
Heart failure
Hepatitis
Hepatitis B
Hepatitis C virus
Hospitals
Infections
Liver cirrhosis
Liver diseases
Medicine
Mortality
National health insurance
Nursing
Original Research
Population-based studies
Systematic review
Taiwan
Telbivudine
Type 2 diabetes
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Summary:Liver cirrhosis is an uncommon but not rare side effect of amiodarone-induced hepatotoxicity. Patients with hepatitis B virus and hepatitis C virus infections are at a high risk for developing liver cirrhosis. However, the relationship between this treatment and risk of liver cirrhosis in high-risk chronic hepatitis B and chronic hepatitis C patients is unknown. The present study identified amiodarone users (N=8,081) from the Taiwan National Health Insurance Research Database from 1997 through 2013. A total of 32,324 subjects with age, comorbidities, gender, and index date-matched non-amiodarone users were selected as controls (non-amiodarone cohort). The incidences of cumulative liver cirrhosis were compared between cohorts. Stratified Cox's regression hazard models were used to assess possible comorbidity-attributable risks for liver cirrhosis. The amiodarone cohort had a nonsignificant risk of liver cirrhosis compared with the non-amiodarone cohort, with a HR of 1.17 (95% CI: 0.93-1.47; =0.1723). Patients with specific comorbid diseases, including type 2 diabetes mellitus, chronic hepatitis B, chronic hepatitis C, and heart failure, were probably at a high risk of developing liver cirrhosis. The use of statins was associated with a significant 42% reduction in the risk of liver cirrhosis. Patients in the amiodarone cohort had no excess risk of liver cirrhosis compared with patients in the non-amiodarone cohort. Long-term surveillance for liver toxicity in high-risk patients with amiodarone treatment is suggested.
ISSN:1176-6336
1178-203X
1178-203X
DOI:10.2147/TCRM.S174868