Posted: Tuesday, July 25, 2023
Regular statin use may decrease the risk of liver disease, hepatocellular carcinoma, and liver-related deaths, according to research published in JAMA Network Open. In a large, multinational study, Carolin Victoria Schneider, MD, of University Hospital RWTH Aachen, Germany, and colleagues observed a significant association between statin intake and liver disease protection, and they considered whether statins should be recommended to individuals at high risk for liver disease. In light of their findings, the investigators advised that patients who fall into specific risk categories be thoroughly evaluated for indications for taking statins, and they recommended clinical trials to evaluate drug repurposing for primary and secondary prevention of liver diseases.
A total of 1,785,491 individuals from three independent cohorts were included in the study, all of which offered longitudinal data: UK Biobank (baseline from 2006 to 2010, through the end of follow-up in May 2021), TriNetX (baseline from 2011 to 2020, through the end of follow-up in September 2022), and Penn Medicine Biobank (ongoing enrollment from 2013 through the end of follow-up in December 2020).
Overall, the researchers observed a total of 581 cases of liver-associated death, 472 cases of incident hepatocellular carcinoma, and 98,497 new liver diseases during the follow-up periods. In UK Biobank individuals without previously diagnosed liver disease, statin users had a 15% lower hazard ratio for the association of developing a new liver disease, a 28% lower hazard ratio for the association with liver-related death, and a 42% lower hazard ratio for the development of hepatocellular carcinoma. In the TriNetX cohort, the hazard ratio for developing hepatocellular carcinoma was 74% lower for statin users.
Taking statins appeared particularly beneficial in men, individuals with diabetes, and individuals with a high Fibrosis-4 Index (a liver fibrosis marker) at baseline. Also of note, carriers of the heterozygous minor allele of PNPLA3 rs738409 had a 69% lower hazard ratio for association with hepatocellular carcinoma.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.