Medical therapy for polycystic liver disease

Area of Science:

• Hepatology
• Pharmacology
• Medical Research

Background:

• Polycystic liver disease (PCLD) management options include somatostatin analogues and rapamycin inhibitors.
• The comparative efficacy and impact of these drug classes on PCLD are not fully established.

Purpose of the Study:

• To systematically review the literature on the medical management of polycystic liver disease.
• To assess the impact of somatostatin analogues and rapamycin inhibitors on liver volume and quality of life.

Main Methods:

• Systematic literature review of English-language studies (1966-August 2014) from MEDLINE, PubMed, Embase, and Cochrane Library.
• Included randomized trials and controlled studies, with reference list searches for additional publications.
• Studies were appraised using the Jadad score.

Main Results:

• Seven studies were included. Five studies (3 randomized trials) on somatostatin analogues showed mean liver volume reduction from 2.9% at 6 months to 4.95 ±6.77% at 1 year.
• One randomized trial on rapamycin inhibitors (everolimus and octreotide vs. octreotide) found no significant difference in liver volume reduction (3.5% vs. 3.8%, p=0.73).
• Two randomized trials on somatostatin analogues showed modest improvements in quality of life (SF-36), with some subdomain scores improving.

Conclusions:

• Somatostatin analogues significantly reduce liver volumes in PCLD patients within six months.
• While somatostatin analogues offer modest improvements in quality of life, rapamycin inhibitors do not provide additional therapeutic advantages.