Statin use tied to lower mortality in alcoholic cirrhosis

Last Updated: 2017-09-19

By Anne Harding

NEW YORK (Reuters Health) - Patients with alcoholic cirrhosis who take statins have a lower mortality rate than those who do not take the cholesterol-lowering drugs, new research shows.

"Statins are safe to use in patients with alcoholic cirrhosis," Dr. Ulrich Bang of University Hospital of Hvidovre in Denmark, one of the study's authors, told Reuters Health in a telephone interview. "We can use them without worries, because traditionally we have been afraid of toxicity to the liver."

He added that the study "supports that statins may have an anti-inflammatory effect, and maybe it is beneficial for these patients to use statins, but we need a randomized controlled trial before a firm recommendation can be made."

Statins are associated with a reduced risk of death and decompensation in patients with cirrhosis caused by hepatitis B or C virus infection. However, the drugs' effects in patients with alcoholic cirrhosis have not been investigated in population-based studies, Dr. Bang and his team note in their September 7 online report in Alimentary Pharmacology and Therapeutics.

The researchers used Danish registry data, for 1995 through 2014, to identify 24,748 patients with alcoholic cirrhosis. Of 5,417 who were eligible for propensity-score matching, 744 were included in a matched cohort comparing patients who were prescribed statins (15% of the cohort) with those not prescribed statins.

The statin group had a significantly lower mortality rate than the non-statin group (88 vs. 127 deaths per 1,000 person-years; hazard ratio, 0.57). The more consistently prescription claims for a statin were filled, the lower the patient mortality rate. However, mortality risk was not associated with the statin dose.

Statins have been linked to multiple health benefits, but studies have not accounted for the "healthy adherer profile," Dr. Bang noted. "The people who adhere the best have better survival, there's a lower prevalence of smoking and alcohol intoxication, and also the mean annual income is higher in this group."

He and his colleagues did adjust for this behavior, and the association of statins with lower mortality remained significant.

"Our study is the first to really introduce these methods so we can try to mimic the randomized trials," Dr. Bang said.

SOURCE: http://bit.ly/2f1aDjU

Aliment Pharmacol Ther 2017.