Warfarin could prevent liver failure in hepatitis C patients

UK study reveals that blood-thinning drug cuts liver fibrosis.

Liver biopsy of a patient with hepatitis C
Liver biopsy of a patient with hepatitis C

Warfarin could be used to prevent liver failure in thousands of patients with hepatitis C, a study suggests.

UK researchers found that warfarin significantly reduced the level of liver fibrosis in mice with chronic liver injury.

Digital image analysis of liver histology of wild-type mice treated with warfarin showed a 33 per cent reduction in mean fibrosis area compared with controls.

The alpha-smooth muscle actin, which is a biochemical marker of fibrosis at a cellular level, was also reduced by 10 per cent in wild-type mice treated with warfarin.

It follows previous research by the same group that found patients prone to blood clotting who have hepatitis C have accelerated liver scarring.

The researchers have now begun a two-year multi-centre trial, funded by the Medical Research Council (MRC), in 90 hepatitis C patients who have had liver transplants. These patients suffer rapid progression to fibrosis, and the follow-up trial should bring faster results, the researchers say.

Study lead Dr Quentin Anstee, MRC clinical research fellow at Imperial College London, said: 'If we have positive results from the new trial, we will have a potential treatment that is already available, very cheap, and should be safe enough for people to take.'

Dr Anstee hopes that if warfarin proves successful in treating liver damage in hepatitis C, it could be used to treat liver damage from other causes.

But he urged GPs not to prescribe warfarin for hepatitis C patients until results of the new study - expected in around three years' time - confirm the findings in humans.

Dr Richard Stevens, a GP in Oxford and outgoing chairman of the Primary Care Society for Gastroenterology, said the results could be 'good news' for patients. But he warned that warfarin may not be suitable for injecting drug users, a group in which hepatitis C is common.

GPletters@haymarket.com

J Thromb Haemostasis 2008; 6: 1,336-43

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