Clinical

Losartan may reduce liver fibrosis in hepatitis C patients

Last Updated: 2006-02-10 16:31:26 -0400 (Reuters Health)

By Mat�as A. Loewy

BUENOS AIRES (Reuters Health) - Antihypertensive drug losartan may reduce liver fibrosis in patients with chronic hepatitis C infection who do not respond to the standard antiviral therapy, the results of a pilot study suggest.

Dr. Silvia Sookoian, and colleagues at the University of Buenos Aires Medical Research Institute Alejandro Lanari, enrolled 14 hepatitis C patients with biopsy-proven fibrosis (median age= 49. 6 years old) who did not respond to interferon plus ribavirin therapy or who did not comply with treatment. The subjects received 50 mg/day of losartan.

After 6 months, "a decrease in fibrosis stage was observed in 7/14 (treated) patients vs 1/9 control patients" (p< 0,04), authors reported in the current issue of the World Journal of Gastroenterology.

The drug was well tolerated and only one treated patient had a single episode of mild orthostatic hypotension.

"Our findings should be confirmed in a randomized, controlled trial with a larger number of patients. But losartan appears to be a safe drug and it also diminishes portal hypertension in a high proportion of patients," Dr. Sookoian told Reuters Health.

Losartan and other drugs with antifibrotic activity might become a feasible option for the 50% to 70% of patients who do not respond to the current hepatitis C treatment.

Losartan, an angiotensin II type 1 receptor blocker, appears to prevent liver fibrosis and portal hypertension by blocking circulating angiotensin II-mediated activation of hepatic stellate cells.

"Much evidence suggests that hepatic stellate cells play important roles in the pathogenesis of liver fibrosis, since they were shown to undergo (an activation) during the (chronic) injury," researchers add.

World J Gastroenterol 2005;11:7560-7563.