Most Read Articles
5 days ago
Non-alcoholic fatty liver disease (NAFLD) – a clinicopathological spectrum comprising hepatic steatosis or non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH) – is the hepatic manifestation of metabolic syndrome recognized as a leading cause of liver morbidity and mortality. Dr Loo Wai Mun, Consultant at the Division of Gastroenterology and Hepatology, National University Hospital, Singapore, speaks with Audrey Abella to discuss how NAFLD can be best managed in primary care.
Elvira Manzano, 07 Dec 2018
Systemic administration of the gene therapy scAAV2/8-LP1-hFIXco to patients with severe haemophilia B led to stable therapeutic expression of the factor IX gene over 8 years without evidence of late toxicities from treatment, according to a long-term follow-up study.

No link between thrombopoietin receptor agonists use and portal vein thrombosis in CLD

13 Jan 2019

Thrombopoietin receptor agonists (TPORAs) show no clear association with portal vein thrombosis (PVT) when used to treat patients with chronic liver disease (CLD), reports a recent meta-analysis.

A pooled analysis of four studies (n=1,953 CLD patients) showed that there was no significant increase in the incidence of PVT in patients treated with TPORAs compared with those who received placebo (odds ratio [OR], 2.8; 95 percent CI, 0.97–8.16; p=0.055).

The TPORAs tested in the studies were eltrombopag, avatrombopag and lusutrombopag. While there were no significant publication bias (p=0.4) and evidence of heterogeneity (p=0.718) among the studies, the correlation between PVT and TPORA use achieved statistical significance when analysis was restricted to patients treated with eltrombopag (OR, 3.8; 1.14–13.2; p=0.03).

Moreover, in two studies including 1,727 patients, the rates of arterial and venous thromboembolic events were 3.6 percent and 1.1 percent in those who received eltrombopag or placebo, respectively. This corresponded to a significant difference (OR, 3.4; 1.5–7.7; p=0.003).

In a subsequent analysis including three studies (n=514 patients), there was no significant link between TPORA use and PVT incidence in patients with liver disease and thrombocytopaenia undergoing elective invasive procedures (vs placebo: 2.8 percent vs 0.9 percent; OR, 2.6; 0.6–11.6; p=0.212). Heterogeneity and publication bias were likewise nonsignificant.

In the present meta-analysis, the databases of PubMed, SCOPUS, Cochrane and ISI Web of Science were accessed. Aside from case reports, commentaries, review articles and animal studies, papers that did not include an untreated control group were ineligible for inclusion.

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Most Read Articles
5 days ago
Non-alcoholic fatty liver disease (NAFLD) – a clinicopathological spectrum comprising hepatic steatosis or non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH) – is the hepatic manifestation of metabolic syndrome recognized as a leading cause of liver morbidity and mortality. Dr Loo Wai Mun, Consultant at the Division of Gastroenterology and Hepatology, National University Hospital, Singapore, speaks with Audrey Abella to discuss how NAFLD can be best managed in primary care.
Elvira Manzano, 07 Dec 2018
Systemic administration of the gene therapy scAAV2/8-LP1-hFIXco to patients with severe haemophilia B led to stable therapeutic expression of the factor IX gene over 8 years without evidence of late toxicities from treatment, according to a long-term follow-up study.