Daily aspirin use may prevent fibrosis progression in nonalcoholic fatty liver disease
Use of aspirin on a daily basis appears to be associated with less severe histologic features of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), as well as reduce the risk of progression to advanced fibrosis with time, a study has found.
Researchers examined 361 adults with biopsy-confirmed NAFLD every 3–12 months for incident advanced fibrosis defined using serial measurements of validated indices (the Fibrosis-4, NAFLD fibrosis score and aspartate aminotransferase to platelet ratio indices). Liver biopsies were collected at baseline for histologic analyses.
At baseline, 151 patients reported daily aspirin use. Compared with nonregular users, daily users had a significantly lower likelihood of NASH (adjusted odds ratio [aOR], 0.68, 95 percent CI, 0.37–0.89) and fibrosis (aOR, 0.54, 0.31–0.82).
In the group of patients with baseline F0-F2 fibrosis (n=317), 86 developed advanced fibrosis over 3,692 person-years. Daily aspirin use was associated with a significantly lower risk of developing incident advanced fibrosis compared with nonregular users (adjusted hazard ratio [aHR], 0.63, 0.43–0.85).
The relationship between fibrosis progression and aspirin use was dependent of duration of use (p-trend=0.026), with the greatest benefit found in daily aspirin users for ≥4 years (aHR, 0.50, 0.35–0.73).
In contrast, use of nonaspirin nonsteroidal anti-inflammatory drugs was not associated with the risk of advanced fibrosis (aHR, 0.93, 0.81–1.05).