Certain Statins May Reduce Long-Term HCC Risk Among Individuals With Viral Hepatitis

The use of lipophilic statins significantly reduces hepatocellular carcinoma (HCC) incidence and mortality among individuals with viral hepatitis, according to findings of a new study. The findings further suggest that hydrophilic statins do not have the same effect.

The researchers analyzed data on 16,668 participants with viral hepatitis collected from Swedish registers from 2005 to 2013.  

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Among the participants, 8334 received treatment with statins and 8334 did not. Of those who received statins, 6554 received lipophilic statins and 1780 received hydrophilic statins.

The 10-year HCC risk was significantly lower among participants who received lipophilic statins compared with matched participants who did not receive statins (3.3% vs 8.1%). The absolute risk difference (RD) was −4.8 percentage points (95% CI, −6.2 to −3.3). 

The 10-year HCC risk was not significantly lower among participants who received hydrophilic statins compared with matched participants who did not receive statins (6.8% vs 8.0%). The absolute risk difference was −1.2 percentage points (95% CI, −2.6 to 0.4).

The inverse association between lipophilic statins and HCC risk appeared to be dose-dependent, the authors noted.

The 10-year HCC risk among individuals who received treatment with statins was lowest with 600 or more cumulative defined daily doses of lipophilic statins compared with those who did not receive treatment with statins (8.4% vs 2.5%). The absolute RD was −5.9 percentage points (95% CI, −7.6 to −4.2).

The 10-year mortality rate was significantly lower among participants who received lipophilic statins compared with those who did not (15.2% vs 7.3%). The absolute RD was −7.9 percentage points (95% CI, −9.6 to −6.2).

The 10-year mortality rate was also significantly lower among participants who received hydrophilic statins compared with those who did not (16.0% vs 11.5%). The absolute RD was −4.5 percentage points (95% CI, −6.0 to −3.0).

“Further research is needed to determine whether lipophilic statin therapy is feasible for prevention of HCC,” the authors concluded. 

—Colleen Murphy

Reference:

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 [published online August 20, 2019]. Ann Intern Med. doi:10.7326/M18-2753.