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

Authors Huang CH, Lai YY, Kuo YJ, Yang SC, Chang YJ, Chang KK, Chen WK

Received 21 May 2018

Accepted for publication 16 October 2018

Published 10 January 2019 Volume 2019:15 Pages 103—112


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Deyun Wang

Ching-Hui Huang,1–3,* Ya-Yun Lai,4,* Yu-Jui Kuo,4,5 Su-Ching Yang,6 Yu-Jun Chang,7 Kuo-Kuan Chang,8 Wen-Kang Chen4

1Division of Cardiology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan; 2Department of Beauty Science, Graduate Institute of Beauty Science Technology, Chienkuo Technology University, Changhua, Taiwan; 3School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; 4Department of Applied Cosmetology, National Tainan Junior College of Nursing, Tainan, Taiwan; 5Department of Traditional Chinese Medicine, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan; 6Department of Nursing, National Tainan Junior College of Nursing, Tainan, Taiwan; 7Epidemiology and Biostatistics Center, Changhua Christian Hospital, Changhua, Taiwan; 8Department of Hepatogastroenterology, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan

*These authors contributed equally to this work

Background: 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.
Patients and methods: 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.
Results: 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; P=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.
Conclusion: 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.

Keywords: amiodarone, liver cirrhosis, Taiwan, hepatitis

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