Breakthrough in Statin Research: Beyond Cholesterol Reduction, a Guardian for Liver Health

A recent study published in JAMA Internal Medicine has shed new light on the role of statins in treating chronic liver disease, revealing benefits that extend far beyond their well-known cholesterol-lowering effects.

Chronic liver disease, including non-alcoholic fatty liver disease (NAFLD), is a significant risk factor for liver cancer. Statins, cornerstone treatments for lowering cholesterol, have been found to have potential protective effects against liver disease progression and liver cancer. However, previous research has primarily focused on specific types of chronic liver disease, with limited evidence on the relationship between statin use and liver fibrosis progression over time.

This study analyzed data from the Research Patient Data Registry (RPDR) in Massachusetts, covering over 4 million patients. The researchers identified 16,501 patients aged 40 and above with chronic liver disease, including 3,160 statin users and 12,891 non-users. They evaluated the effects of five lipophilic statins (atorvastatin, fluvastatin, lovastatin, pitavastatin, and simvastatin) and two hydrophilic statins (rosuvastatin and pravastatin).

The results showed that statin users were older and had more comorbidities, such as diabetes, hypertension, and coronary artery disease. During a median follow-up period of 4.6 years for users and 2.8 years for non-users, the researchers observed 755 new cases of liver cancer and 2,011 cases of decompensated liver disease. Statin users had a significantly lower risk of liver cancer (33% reduction) and decompensated liver disease (22% reduction) compared to non-users.

The study also found that the association between statin use and reduced liver disease risk was consistent across different types of statins, with lipophilic statins showing a slightly more pronounced effect. Furthermore, the researchers observed a dose-response relationship, with higher cumulative doses of statins (≥600 defined daily doses) associated with lower risks of liver cancer and decompensated liver disease.

Using the FIB-4 index to assess liver fibrosis progression, the researchers found that statin use was associated with improved FIB-4 scores. Specifically, statin users had a lower proportion of patients progressing to high FIB-4 scores and a higher proportion of patients reverting to lower FIB-4 scores.

In conclusion, this study demonstrates that statins have a protective effect against liver disease progression and liver cancer in patients with chronic liver disease. The findings suggest that statins may also improve liver fibrosis progression over time. This research provides new insights into the potential benefits of statins in liver disease management and highlights the importance of considering statin therapy in patients with chronic liver disease.