There have been a number of studies suggesting a beneficial effect of statins for individuals chronic liver disease due to HBV infection, HCV infection, and nonalcoholic steatohepatitis. The potential reasons include lower portal hypertension due to increased nitric oxide availability, anti-inflammatory effects through reduction in some cytokines, and antifibrotic effects. In addition, statins may inhibit tumor initiation/hepatocellular carcinoma (HCC).
The background on these prior studies is detailed in a new population-based study (F-M Chang et al Hepatology 2017; 66: 896-907, editorial 697-9) of statins in patients with cirrhosis. In this nested case-control study from Taiwan, the authors examined patients (n=1350) with cirrhosis from 2000 to 2013. The index cases of cirrhosis were identified among a representative, well-validated general population database of 1,000,000 people.
- “Statin use decreased the risk of decompensation, mortality, and HCC in a dose-dependent manner.”
- Risk of decompensation among chronic HBV statin users, HR 0.39
- Risk of decompensation among chronic HCV statin users, HR 0.51
- Risk of decompensation among alcohol-related cirrhosis patients taking statins, HR 0.69
My take: In adults with cirrhosis, particularly HBV-related and HCV-related, taking a statin was associated with a 50-60% lower likelihood of decompensation. A prospective study could confirm these findings.