Thanks for the link. The early result is encouraging. What's really great is that this drug is already approved for hypertension and is being used widely. This makes clinical trials much easier and allows for off-label use by hepatologists.
Interestingly, the U.S. and Europe have given up on making recommendations for a one size fits all approach to hypertension. There is now more focus on treating hypertension while taking into consideration other comorbidities. For instance, a patient with HTN and history of heart attack would get a beta blocker as the primary HTN drug while someone with diabetes would get an ACE inhibitor to protect their kidneys. The same consideration might be given patients with liver disease if this pans out.
Facta non Verba
Wow, this is very encouraging. With late fibrosis/early cirrhosis, I’ve always got my antennae up for things like this. I’ll discuss it with my hepatologist at tomorrow’s appointment--
Jeff; thanks for your commentary as well,
This sounds very encouraging. Thanks for posting BelB64.
Has anyone discussed this with their doc yet? For someone with portal hypertension, this may be a 2 for 1.
thanks I printed this out and will take it to my Hepatologist next week. With late Fibrosis/late cirrhosis maybe he will be wiling to give it a try. I am already on Betapace-a channel blocker for heart problems and also have Portal Hypertension between the liver and spleen. Hope the losartan wouldn't clash with the Betapace-likely though-my luck
Bill, if you are LateFibrosis/Early Cirrhosis how was that determined? I was diagnosed End Stage after one major bleed and one bout with Mental Encephalopathy and Ascites
two taps but now my levels are in range except I am taking Lactulose to control Ammonia levels. Thanks franke566
I tried to talk to my husbands P.A. about Losartan (Cozaar) and she just kind of blew me off. If we actually got to see the Dr., he would probably discuss it with us but she doesn't even want to hear about it. Joe has esophageal varicies and Nadolol is what they think is best. I read a study that showed an increase in platelets and albumin levels and subjects with liver disease. I will be watching the news on this. I saw an older study that showed Losartan to be just as good as Nadolol (Propranalol) at lowering portal pressure but they had a later study that supposedly still shows Nadolol to be better . If it is even almost as good, it might be worth the risk to get rid of some liver scarring for stage 4's like my husband. It is pretty hard to get Dr's to do much off the beaten path but we have pretty well exhausted the beaten path to no avail.
If you do some research on Cozaar (Losartan), you will find studies demonstrating that it has great potential to decrease fibrosis by its basic action, and also has been studies for its documented positive effects on erectile dysfunction, and on depression. My GP read the studies and switched me to this drug about 18 months ago. I like the overall effect, and agree with the above studies cited, from my own anecdotal experience. Definitely a mood enhancer, and seems to assist in the ED area as well.
Most docs usually do not know much about these research studies, so you have to work with them to get things to happen. I view doctors as paid consultants. Its a partnership, and both sides bring ideas and knowledge, and research to the table for discussion. I look to my doctors to make well educated decisions in conjunction with my own input, and debate. In the end, they usually figure out the best approach, and also help identify dangers, and unforseen pitfalls of some suggestions. The Cozaar is a legitimate idea, I believe, for those who already are using BP medications. Added benefits for free!!!
Researchers believe that the drug blocks the signalling pathway so that the liver myofibroblasts die, removing the source of scar tissue. As the scar tissue breaks up, the damaged area of the liver is repaired by the body.
So this stuff serves to prevent new scar tissue vs. melting away the old.
As I understand from HR, the l;iver is constantly laying down new scarring as it digests old - a biological response to the stresses it's under from processing our meals. His approach was to eat in a fashion that prevented the initial dmage, thus preventing new scarring, and allowing the digestion process to gain headway.
This is very promising, especially if t's already proven not to have adverse affects. Other tested compoinds have harmed other areas, like joint cartilage.
My doc said this is the preliminary results of a very small trial. He is reluctant to endorse this to cirrhosis patients because there is not enough information on the risk/benefit based on this small study. Cirrhosis and this disease *****!
I posed a question regarding this to Dr. Schiano at the transplant forum. Below is the question and his response.
With the new info suggesting that Losartan may help with liver fibrosis, do you think that it is appropriate to prescribe this for a patient with portal hypertension? Thank you.
by Thomas D Schiano, MD
there is definitely some suggestion that this family of medications may be helpful. they can be somewhat problematic to use and would need to be used for years before potentially seeing an affect. definitely not standard of care yet in my eyes.
I'm really lucky, although Jim might not believe it. My gastroenterolgist, after reading a Mayo Clinic study and UMass Study, over 2 years ago, put me on diovan which is an angiotensin bp drug. That is the one used in those particular studies with the same results as losarten, which is also an angiotensin drug. I have no problem with it at all. In fact my bp did not change when we added it to my regime of toprol and norvasc. The beta blockers used for late stage cirrhosis are not the same ones used mainly for bp in patients. They are highly selective from what I understand. In other words if I needed onem, which I don't, it wouldn't be toprol.
As with just about all medications, there are side effects. Losartan has its share as well. I feel if you're going to try this as a Fibrosis reversal opportunistic treatment, you should evaluate the side effects and certainly ask your doctor's opinion.
As with pretty much all blood pressure medications, there is that ever gnawing and threatening sexual disfunctionality.
Here's a link to the side effects:
While the above states that less than 1% using cozaar will develop sexual dysfunction....the following study shows over 88% had increased and enhanced sexual function. I like the odds! It also improves mood in many people, according to the study!