Lipophilic statins may be associated with significantly reducing the incidence of hepatocellular carcinoma (HCC) and mortality, according to study results published in the Annals of Internal Medicine.
Approximately 500,000 cases of HCC are diagnosed worldwide each year, and data suggest that in chronic liver disease 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) may improve clinical outcomes and reduce HCC risk. However, the influence of different statin classes on HCC risk and survival is unknown. Therefore, researchers assessed the relationship between lipophilic or hydrophilic statin use and HCC incidence and mortality in a nationwide population with viral hepatitis in Sweden.
Patients included a propensity score-matched cohort of 16,668 adults (8334 who initiated statin use [6554 lipophilic and 1780 hydrophilic] and 8334 nonusers) among 63,279 eligible adults (15,104 with hepatitis B virus infection and 48,175 with hepatitis C virus infection). Compared with nonusers, the 10-year HCC risk was significantly lower in lipophilic statin users (8.1% vs 3.3%) but not hydrophilic statin users (8.0% vs 6.8%). However, the inverse association between lipophilic statins and HCC risk seemed to be dose-dependent as the 10-year HCC risk was lowest with 600 or more lipophilic statin cumulative defined daily doses compared with nonusers (2.5% vs 8.4%). In addition, 10-year mortality was significantly lower in both lipophilic (7.3% vs 15.2%) and hydrophilic (11.5% vs 16.0%) statin users compared with nonusers.
The researchers concluded, “In a nationwide viral hepatitis cohort, lipophilic statins were associated with significantly reduced HCC incidence and mortality.” They added, “Further research is needed to determine whether lipophilic statin therapy is feasible for prevention of HCC.”
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
Simon TG, Duberg A-S, Aleman S, et al. Lipophilic statins and risk for hepatocellular carcinoma and death in patients with chronic viral hepatitis: results from a nationwide Swedish population. Ann Intern Med 2019;171:318-327.