Using a retrospective population-based cohort, the researchers demonstrate that diabetic individuals with severe chronic kidney disease or end-stage renal disease who use acarbose do not have an increased risk of hepatotoxic events regardless of their background hepatic disease severity during follow-up, according to a new study led by Professor Kuo-Liong Chien and his PhD student, Mr. Jui Wang, at the National Taiwan University College of Public Health. This study has been published online on 07 August 2018 in Frontiers in Pharmacology.
“Acarbose has long been deemed contraindicated in diabetic patients with renal failure or hepatic dysfunction due to the fear of hepatotoxicity risk; however, whether this concern is valid needs re-examination in the contemporary era.” said Dr. Chia-Ter Chao, the first author of the paper who has been involved in this study. This study is the first study trying to answer this question based on a more rigorous study design.
By analyzing propensity score-matched acarbose users and non-users with different degrees of chronic liver disease (CLD) (6732 without CLD, 805 with CLD, and 357 with cirrhosis), users did not exhibit an increased incidence of hepatotoxic events during follow-up, compared with diabetic non-users, after adjusting for demographic profiles, comorbidities, diabetic severity, and other potentially hepatotoxic medications.
The finding of a relatively safe hepatic profile of acarbose among at-risk patients can be of significant interest and requires further discussion. These findings may support the renaissance of acarbose as a useful adjunct in diabetic patients with severe chronic kidney disease with or without liver diseases.