Long-term albumin improves the outcomes of patients with decompensated cirrhosis and diabetes mellitus: Post hoc analysis of the ANSWER trial

Liver Int. 2024 Sep;44(9):2108-2113. doi: 10.1111/liv.16020. Epub 2024 Jun 27.

Abstract

Type-2 diabetes mellitus is a frequent comorbidity of cirrhosis independently associated with cirrhosis-related complications and mortality. This post hoc analysis of the ANSWER trial database assessed the effects of long-term human albumin (HA) administration on top of the standard medical treatment (SMT) on the clinical outcomes of a subgroup of 85 outpatients with liver cirrhosis, uncomplicated ascites and insulin-treated diabetes mellitus type 2 (ITDM). Compared to patients in the SMT arm, the SMT + HA group showed a better overall survival (86% vs. 57%, p = .016) and lower incidence rates of paracenteses, overt hepatic encephalopathy, bacterial infections, renal dysfunction and electrolyte disorders. Hospital admissions did not differ between the two arms, but the number of days spent in hospital was lower in the SMT + HA group. In conclusion, in a subgroup of ITDM outpatients with decompensated cirrhosis and ascites, long-term HA administration was associated with better survival and a lower incidence of cirrhosis-related complications.

Keywords: ascites; bacterial infections; diabetes mellitus; hepatic encephalopathy; long‐term albumin treatment; renal dysfunction; survival.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Albumins / administration & dosage
  • Albumins / therapeutic use
  • Ascites* / drug therapy
  • Ascites* / etiology
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Female
  • Humans
  • Insulin / therapeutic use
  • Liver Cirrhosis* / complications
  • Liver Cirrhosis* / drug therapy
  • Liver Cirrhosis* / mortality
  • Male
  • Middle Aged
  • Treatment Outcome

Substances

  • Albumins
  • Insulin