Magazine: Hepatitis Weekly; May 19, 1997 Section: World News;
Informative Worldwide Briefs Therapy (HCV)
Long-term administration of Stronger Neo-Minophagen C is
effective in preventing liver cancer in patients with chronic
hepatitis C, according to a study from Japan.
"The reason why Stronger Neo-Minophagen C (SNMC) administration
reduces hepatocarcinogenesis is believed to be related to the
suppression of the necroinflammatory reaction in the liver and the
protection against histologic aggravation," researcher Yasuji Arase
and colleagues wrote ("The Long Term Efficacy of Glycyrrhizin in
Chronic Hepatitis C Patients," Cancer, April 15,
1997;79(8):1494-1500).
It has been suggested that as many as 80 percent of
hepatocellular carcinoma (HCC) patients have RNA for the hepatitis
C virus (HCV). The yearly incidence of HCC in patients with HCV RNA
positive cirrhosis ranges from 5-7 percent in Japan.
In Japan, SNMC has long been used in the form of an intravenous
solution, comprised of 0.2 percent Glycyrrhizin (GL), 0.1 percent
Cysteine, and 2.0 percent glycine in physiologic solution.
Glycyrrhizin is an aqueous extract of licorice root (Glycyrrhizae
radix), which is antiallergic and has detoxicating effects.
"As has been reported, the anti-inflammatory mechanism of SNMC
is believed to be due to its protective effect on the hepatic
cellular membrane, which may explain its ability to lower the serum
transaminase level in patients with chronic hepatitis," Arase et
al. wrote. "Glycine prevents an aldosteron-like action of GL and
Cysteine has been found to be detoxicative as well as antiallergic
through Cysteine conjugation in the liver.
"Therefore, SNMC has been developed with the expectation of the
joint beneficial effect of these three components."
Arase et al. conducted a retrospective study to evaluate the
long-term preventive effect of SNMC on HCC development. Of 453
patients diagnosed with chronic hepatitis C in the study hospital
between January 1979 and April 1984, 84 patients (Group A) had been
treated with SNMC at a dose of 100 mL daily for eight weeks,
followed by two to seven times a week for two to 16 years (median
10 years).
A separate group of 109 patients (Group B) could not be treated
with SNMC or interferon for a long period of time (median, 9.2
years) and were given other herbal medicines, such as vitamin K.
All patients were monitored retrospectively, and the cumulative
incidence of HCC and risk factors for HCC were examined.
Arase et al. found the tenth year rates of cumulative HCC
incidence for Groups A and B were 7 percent and 12 percent,
respectively, and the 15th-year rates were 12 percent and 25
percent, respectively.
Using Cox regression analysis, the relative risk of HCC
incidence in patients not treated with SNMC (Group B) was 2.49
compared with that of patients treated with SNMC. Moreover, in
patients treated with SNMC, HCC appearance rates in patients with
normal ALT levels was lower than that of patients with abnormal ALT
levels.
The authors concluded that normalization of ALT levels by long
term administration of SNMC will assist in protecting against
hepatocarcinogenesis.
"The reduction in risk of HCC in the SNMC group may be partly
due to improvement in the ALT level," they wrote. "Therefore, SNMC
therapy is believed to help maintain ALT levels within normal
limits."
The corresponding author for this study is Yasuji Arase,
Department of Gastroenterology, Tonanomon Hospital, 2-2-2 Toranomon
Minato-ku, Tokyo, Japan.
Source: Hepatitis Weekly, 05/19/97, p16, 7/8p.
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