title: Therapeutic effect of renin angiotensin system inhibitors on liver fibrosis.
abstract: OBJECTIVE
  Currently, there is no effective therapy available for liver fibrosis. This study aims to evaluate the efficacy of renin angiotensin system inhibitors on liver fibrosis.
  
  
  METHODS
  Full-text randomized controlled trials in patients with liver fibrosis were identified and included in the meta-analysis. The primary outcome measure was the histological fibrosis score of the liver. Secondary outcome measures included fibrosis area of the liver, serological levels of fibrosis markers, adverse events, and withdrawals.
  
  
  RESULTS
  From 6973 non-duplicated entries by systematic search, four randomized controlled trials with 210 patients were identified. The renin angiotensin system inhibitors therapy resulted in a marginally significant reduction in liver fibrosis score (MD = -0.30; 95% CI: -0.62-0.02, p = 0.05) and a significant reduction in liver fibrosis area (MD = -2.36%; 95% CI: -4.22%--0.50%, p = 0.01) as compared with control. The therapy was well tolerated and there was no significant difference in withdrawals between treatment and control groups (RD = 0.00; 95% CI: -0.06-0.06, p = 0.97).
  
  
  CONCLUSIONS
  Renin angiotensin system inhibitor therapy results in a reduction in liver fibrosis score and liver fibrosis area in patients with hepatic fibrosis with good safety profile. However, randomized controlled trials of high-quality will clarify the effectiveness of renin angiotensin system inhibitors on liver fibrosis.
authors.affiliation: Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, China.
authors.forename: Qianqian
authors.initials: Q
authors.lastname: Zhu
authors.affiliation: Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, China.
authors.forename: Na
authors.initials: N
authors.lastname: Li
authors.affiliation: Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Li
authors.affiliation: Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, China.
authors.forename: Zhihua
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, China.
authors.forename: Qunying
authors.initials: Q
authors.lastname: Han
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, China Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Lv
authors.affiliation: Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, China.
authors.forename: Jiao
authors.initials: J
authors.lastname: Sang
authors.affiliation: Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, China Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, China liuzhengwen@medmail.com.cn.
authors.forename: Zhengwen
authors.initials: Z
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012084:Renin-Angiotensin System / Q000187:drug effects; D055815:Young Adult
chemical_list: D057911:Angiotensin Receptor Antagonists; D015415:Biomarkers
keywords: Angiotensin-converting-enzyme inhibitors; angiotensin receptor blocker; liver fibrosis; treatment