Tamoxifen use and potential effects on liver parenchyma: A long-term prospective transient elastographic evaluation

C. Louwrens Braal*, Robert J. de Knegt, Agnes Jager, Stijn L.W. Koolen, Ron H.J. Mathijssen, Karel Eechoute

*Corresponding author for this work

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Abstract

Tamoxifen is a commonly prescribed drug in both early and metastatic breast cancer. Prospective studies in Asian populations demonstrated that tamoxifen-related liver steatosis occurred in more than 30% of the patients within 2 years after start of treatment. No well-designed prospective studies on potential tamoxifen-related liver steatosis have been conducted in Caucasian patients so far. Therefore, our prospective study aimed to assess the incidence of tamoxifen-related liver steatosis for a period of 2 years in a population of Caucasian breast cancer patients treated with tamoxifen. Patients with an indication for adjuvant treatment with tamoxifen were included in this study. Data were collected at 3 months (T1) and at 2 years (T2) after start of tamoxifen treatment (follow-up period of 21 months). For the quantification of liver steatosis, patients underwent liver stiffness measurement by transient elastography with simultaneous controlled attenuation parameter (CAP) determination using the FibroScan. A total of 95 Caucasian breast cancer patients were included in this evaluation. Liver steatosis was observed in 46 of 95 (48%) and 48 of 95 (51%) of the patients at T1 and T2, respectively. No clinically relevant increase in liver steatosis was observed during the treatment period of 2 years with tamoxifen (median CAP = 243 ± 49 dB/m (T1) and 253 ± 55 dB/m (T2), respectively; p = 0.038). Conclusion: In this prospective longitudinal study in Caucasian breast cancer patients, no clinically relevant alterations in liver steatosis in terms of CAP values and liver/lipid parameters were observed after 2 years of tamoxifen treatment. This study therefore demonstrates an absence of tamoxifen-related adverse events such as steatosis and (early) development of fibrosis or cirrhosis during a treatment period of at least 2 years.

Original languageEnglish
Pages (from-to)2565-2568
Number of pages4
JournalHepatology Communications
Volume6
Issue number9
Early online date10 Jun 2022
DOIs
Publication statusPublished - Sept 2022

Bibliographical note

Funding Information:
Supported by an unrestricted MRACE grant (Erasmus MC, the Netherlands); Grant No. 2017–17108.

Funding Information:
Robert J. de Knegt received a research grant from Echosens.

Publisher Copyright:
© 2022 The Authors. Hepatology Communications published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases.

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