Statins lower the risk of cirrhosis in chronic hepatitis B

Last Updated: 2016-05-24

By Will Boggs MD

NEW YORK (Reuters Health) - Statins lower the risk of cirrhosis and its decompensation in patients with chronic hepatitis B, researchers from Taiwan report.

Statins have previously been shown to reduce fibrosis progression and cirrhosis in patients with chronic hepatitis C, but their effects in patients with chronic hepatitis B remain unknown.

Dr. Yi-Wen Huang, from Cathay General Hospital Medical Center, Taipei, Taiwan, and colleagues used data from the National Health Insurance Research Database in Taiwan to investigate the risk of cirrhosis, its complications, and its decompensation in chronic hepatitis B patients who received statin therapy during follow-up.

Among 298,761 chronic hepatitis B patients, they identified 6,543 adult patients taking statins and matched them by propensity score with 6,543 similar adults not taking statins.

After controlling for other factors, patients taking statins were 48.8% less likely than patients not taking statins to develop cirrhosis, according to the May 10 online report in the American Journal of Gastroenterology.

The risk of cirrhosis was also lower among patients receiving triglyceride-lowering drugs.

Patients taking statins were also 46.6% less likely than patients not taking statins to develop decompensated cirrhosis.

These protective effects appeared to be greater with higher dosage and longer duration of statin use.

Reached for comment, Dr. Vijay Shah, Mayo Clinic's chair of gastroenterology and hepatology, Rochester, Minnesota, told Reuters Health by email, "This fits with other recently emerging data suggesting statins can be beneficial in patients with chronic liver disease. It is surprising to many who are used to prior and somewhat outdated concerns about statins and liver test elevations."

"More studies are needed to further support the premise that statins are beneficial for patients with chronic liver disease," Dr. Shah said. "If and when these additional evidences emerge, then statins may be encouraged in this patient population."

Dr. Raymond T. Chung, from Massachusetts General Hospital, Harvard Medical School, Boston, told Reuters Health by email, "Statins given for traditional indications are not contraindicated in persons with chronic liver diseases such as hepatitis B and may even be beneficial. Monitoring of liver function should still continue to occur when patients with chronic liver diseases are placed on statin therapy."

"It is still premature to make a recommendation to treat for this reason, since this was a retrospective analysis of a non-randomized study," explained Dr. Chung, who also wasn't involved in the study. "It is still theoretically possible, for instance, that the choice to treat with and to dose with higher levels of statins could have been influenced by the perceived lack of meaningful liver disease by clinicians. This may have been prompted by a general aversion to prescribing statins to patients with liver disease, which does not appear to be justified in this and other studies."

Dr. Huang did not respond to a request for comments.

The authors reported no external funding or disclosures.

SOURCE: http://bit.ly/1sNTaRd

Am J Gastroenterol 2016.