Statin use, particularly atorvastatin and fluvastatin, was associated with a reduction in incident cirrhosis and hepatocellular carcinoma (HCC) in patients with chronic hepatitis C virus (HCV). Findings from this study were published online in the journal Hepatology.
Previous research has indicated that statins may delay fibrosis progression and reduce HCC risk in HCV patients, however limited data exists regarding which statins should be used and what dose is most effective. In this study, researchers used the Electronically Retrieved Cohort of HCV Infected Veterans database to identify patients on HCV therapy and all incident cases of cirrhosis and HCC from 2001 to 2014. To examine the relationship between statins and development of cirrhosis and HCC, multivariable Cox proportional hazard regression models were used. Cumulative defined daily dose (cDDD) was used to measure statin use.
Among the 9,135 eligible patients, 1,649 developed cirrhosis and 239 developed incident incident HCC. Findings from the study included the following:
- 44% reduction in cirrhosis development with statin use (adjusted HR 0.6, 95% CI 0.53, 0.68)
- Fibrosis progression with statin use: cDDD 28–89: HR 0.74 (0.59, 0.93); cDDD 89–180: HR 0.71 (0.59, 0.88); cDDD >180: HR 0.6 (0.53, 0.68)
- Mean change in FIB-4 score with atorvastatin: –0.17
- Mean change in FIB-4 score with fluvastatin: –0.13
- 49% reduction in incident HCC with statins (adjusted HR 0.51, 95% Cl 0.36, 0.72)
The authors conclude that statin use in chronic HCV patients reduces incident cirrhosis and HCC in a dose-dependent manner. Compared with other statins, atorvastatin and fluvastatin were linked to the most significant anti-fibrotic effects.
For more information visit the journal Hepatology.