Nonselective Beta-blockers Are Associated With a Lower Risk of Hepatocellular Carcinoma Among Cirrhotic Patients in the United States

Karn Wijarnpreecha; Fang Li; Yang Xiang; Xun Xu; Cong Zhu; Vahed Maroufy; Qing Wang; Wei Tao; Yifang Dang; Huy Anh Pham; Yujia Zhou; Jianfu Li; Xinyuan Zhang; Hua Xu; C. Burcin Taner; Liu Yang; Cui Tao


Aliment Pharmacol Ther. 2021;54(4):481-492. 

In This Article


Based on the statistical analysis of population-based data, the current study concluded that carvedilol was associated with a significantly decreased risk of HCC in patients with cirrhosis when compared with no beta-blocker and may have a chemo-protective role in this population. Besides Caucasians, carvedilol may be the drug of choice for Hispanics and African Americans with cirrhosis, given the significant protective effect of HCC among these groups, which was not seen with propranolol and nadolol. Meanwhile, our study also confirmed the HCC protective effect of traditional NSBBs (propranolol and nadolol). Nadolol may be the preferred NSBB for patients with alcohol-associated liver cirrhosis due to HCC protective effect. Future prospective randomised-controlled studies comparing the incidence of HCC among carvedilol, nadolol, and propranolol are warranted to confirm this finding and further elucidate which NSBB could be the best option for the protective effect of HCC in cirrhosis.