Asari Radix et Rhizoma consumption lacks relevance for hepatocellular carcinoma in patients: A retrospective cohort study

OBJECTIVE: Although some studies have linked Asari Radix et Rhizoma (Asari Radix) administration to hepatocellular carcinoma (HCC), few studies have examined the association between the development of HCC and use of Asari Radix among patients in mainland China. This study aimed to evaluate the real-world association between Asari Radix and HCC in patients to strengthen the understanding of Asari Radix safety. METHODS: A retrospective cohort study among hepatitis B virus (HBV)-monoinfected patients and non-HBV-monoinfected patients were performed. Patients over 18 years of age were eligible for inclusion. Prescription records of inpatients and outpatients were inquired to distinguish Asari Radix users and nonusers. The risk of developing HCC among Asari Radix users and nonusers in the HBV cohort and the non-HBV cohort was analyzed. RESULTS: There were 49 500 HBV and 133 148 non-HBV patients involved in the two cohorts. Among HBV patients (2 901 users; 46 599 nonusers), the prevalence of HCC in Asari Radix users was lower than that in nonusers (145.70 vs. 265.43 per 10(5)). Among non-HBV patients (5 042 users; 128 106 nonusers), the prevalence of HCC in Asari Radix users was lower than that in nonusers (81.62 vs. 134.11 per 10(5)). None of the hazard ratios (HRs) of Asari Radix exposure ranging from 1 g to 200 g in the two cohorts showed correlation between Asari Radix exposure and hepatocarcinogenesis. CONCLUSION: An obvious irrelevancy was found between the consumption of Asari Radix and HCC development both in patients with and in those without HBV infection. Use of Asari Radix under 200 g appears safe in terms of HCC risk in the Chinese population; further prospective studies are needed to confirm our results.