Lipophilic statin use in Hepatitis B and C patients lowers risk of liver cancer and death

The researchers at Karolinska Institutet in Stockholm and colleagues have found that Lipophilic statin use was linked to a significantly lower risk of both incident hepatocellular carcinoma (HCC) and death for people with hepatitis B or C virus infection.

For patients with chronic viral hepatitis, the use of lipophilic statins is associated with a lower risk for hepatocellular carcinoma and mortality, according to a new study. The 10-year HCC risk was 44% lower among people taking a lipophilic statin -- atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Altoprev), and simvastatin (Zocor) -- than in propensity-matched nonusers (3.3% vs 8.1%, HR 0.56, 95% CI 0.41-0.79). The study has been published in the Annals of Internal Medicine.

Dr Tracey G. Simon and colleagues conducted a study to assess the relationship between lipophilic or hydrophilic statin use and HCC incidence and mortality in a nationwide population with viral hepatitis.

It is not known whether statin type influences hepatocellular carcinoma (HCC) incidence or mortality in chronic hepatitis B or C virus infection or not.

In the study, a Prospective propensity score (PS)–matched cohort using Swedish registries, roughly 8300 statin users with hepatitis B or C infection were matched to nonusers. Time to incident HCC, ascertained from validated registers. Statin use was defined from filled prescriptions as 30 or more cumulative defined daily doses (cDDDs).Time to incident HCC, ascertained from validated registers. Statin use was defined from filled prescriptions as 30 or more cumulative defined daily doses (cDDDs).

The researchers found that patients who used lipophilic statins (e.g., atorvastatin, simvastatin) had a lower 10-year cumulative incidence of hepatocellular carcinoma than nonusers (3% vs. 8%). Users of hydrophilic statins (e.g., pravastatin, rosuvastatin) did not see the same benefit. Ten-year mortality rates were significantly lower with both groups of statin users (7% for lipophilic statin users vs. 15% for nonusers; 12% for hydrophilic statin users vs. 16% for nonusers).

In a nationwide viral hepatitis cohort, lipophilic statins were associated with significantly reduced HCC incidence and mortality. An association between hydrophilic statins and reduced risk for HCC was not found.Earlier studies have found that lipophilic statins are more effective than hydrophilic statins at preventing viral replication and stimulating antitumor immunity. Further research is needed to determine whether lipophilic statin therapy is feasible for prevention of HCC.

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Annals of Internal Medicine