Lipophilic statins associated with significantly reduced hepatocellular carcinoma incidence, mortality in hepatitis
Potential benefits of lipophilic statins appeared to be dose- and duration-dependent, with the greatest reduction in hepatocellular carcinoma risk seen with use of a moderate-dose statin for about two years, according to data from a registry of Swedish patients with hepatitis B or C.
Lipophilic statins were associated with significantly reduced hepatocellular carcinoma (HCC) incidence and mortality among patients with hepatitis, while hydrophilic statins were not, according to a recent study.
Researchers used 2005 to 2013 data from a nationwide Swedish registry of 63,279 adults with viral hepatitis B or C to assess the relationship between lipophilic or hydrophilic statin use and HCC incidence and mortality. They propensity-matched 8,334 patients who used statins (6,554 lipophilic and 1,780 hydrophilic) with 8,334 patients who did not use statins. Lipophilic statin exposures included simvastatin and atorvastatin, while hydrophilic statin exposures included pravastatin and rosuvastatin. Results were published Aug. 20 by Annals of Internal Medicine.
Compared with matched nonusers, 10-year cumulative incidence of HCC was significantly lower among lipophilic statin users (8.1% vs. 3.3%; absolute risk difference [RD], −4.8 percentage points [95% CI, −6.2 to −3.3 percentage points]; adjusted subdistribution hazard ratio [aHR], 0.56 [95% CI, 0.41 to 0.79]) but not hydrophilic statin users (8.0% vs. 6.8%; RD, −1.2 percentage points [95% CI, −2.6 to 0.4 percentage points]; aHR, 0.95 [95% CI, 0.86 to 1.08]). The apparent benefits of lipophilic statins were dose- and duration-dependent. Compared with nonusers, 10-year risk for HCC was lowest with 600 or more cumulative defined daily doses of a lipophilic statin (8.4% vs. 2.5%; RD, −5.9 percentage points [95% CI, −7.6 to −4.2 percentage points]; aHR, 0.41 [95% CI, 0.32 to 0.61]). Ten-year mortality overall was significantly lower among both lipophilic (15.2% vs. 7.3%; RD, −7.9 percentage points [95% CI, −9.6 to −6.2 percentage points]) and hydrophilic (16.0% vs. 11.5%; RD, −4.5 percentage points [95% CI, −6.0 to −3.0 percentage points]) statin users.
According to the researchers, these findings confirm prior data linking statins with improved survival and reduced cancer risk in chronic liver disease, although more research is needed to determine whether lipophilic statin therapy is feasible for preventing HCC, the authors wrote. They also noted that there was no significant association between hydrophilic statin use and HCC risk.
“These findings support further research to characterize the potential hepatoprotective benefits of lipophilic statins,” the authors wrote.