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Efficacy and safety of AnluoHuaxian pills on chronic hepatitis B with normal or minimally elevated alanine transaminase and early liver fibrosis: A randomized controlled trial

Huan-Ming Xiao, Mei-Jie Shi, Jun-min Jiang, Gao-Shu Cai, Yu-Bao Xie, G. Tian, J. Xue, D. Mao et al.

Journal of Ethnopharmacology, 2022

270 participants · 20 citations

Abstract

ETHNOPHARMACOLOGICAL RELEVANCE

The AnluoHuaxian pill (AHP) is a widely used patented medicine for chronic hepatitis B (CHB) patients withadvanced fibrosis or cirrhosisthat has been used in China for more than 15 years. However, data are lacking on whether monotherapy with AHP can be effective in CHB patients with alanine aminotransferase (ALT) levels less than 2 times the upper limit of normal (ALT<2ULN) and early liver fibrosis (F ≤ 2).

AIM OF THE STUDY

We aimed to investigate whether monotherapy with AHP improves liver histology in these patients.

MATERIALS AND METHODS

In this double-blind, randomized, placebo-controlled trial, 270 CHB patients with ALT<2ULN and F ≤ 2 were treated in 12 hospitals in China. The patients were randomly assigned to an intervention (AHP) group and a placebo group at a ratio of 2:1. Of these 270 enrolled patients, 147 had paired liver biopsies. The primary end point was histological change after 48 weeks of treatment.

RESULTS

Per-protocol analysis revealed that the rate of histologic improvement in liver fibrosis patients in the AHP group was significantly higher than that in the placebo group (37.7% vs. 19.5%, P = 0.035) after 48 weeks of treatment, which was consistent with results from intention-to-treat and sensitivity analyses. Moreover, after adjusting for baseline characteristics, AHP was superior to placebo with respect to improving liver fibrosis (odds ratio [OR] = 2.58, 95% confidence interval [CI]: (1.01, 6.63),P = 0.049) and liver…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 270 participants or records.

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