This article is more than 5 years old. Information may no longer be current.

Statin use decreases HCC risk in HBV patients

In a retrospective cohort study, statin use was found to be associated with a reduced risk of hepatocellular carcinoma among patients with hepatitis B virus infection, according to study data.

“We investigated the effect of statin in the primary prevention of HCC in a hospital-based population of HBV patients, by correcting for any potential confounders and biases,” the researchers wrote. “We also examined the effect of statin among other high-risk subgroups to evaluate the potential clinical use and impact of statin.”

Researchers extracted and analyzed data of 73,499 patients with HBV from the Hospital Authority registry database, which contained data of patients from 43 hospitals and 120 clinics in Hong Kong territory, between January 2000 and December 2012. This data was retrieved after researchers searched the database looking for specific ICD-9 codes and hepatitis B surface antigen (HBsAg) positivity. Of these patients, 53,513 were included in the final analysis. Researchers found that 1,176 of these patients were statin users and 52,337 patients were not.

Over a median follow-up of 4.6 years, 6,883 cases of HCC developed in 393,154 patient-years, according to the research. The crude incidence rate of HCC was 1.75 per 100 patient-years (95% CI, 1.71-1.79). After a 2-year landmark analysis, the median follow-up after the landmark date was 1.6 years for statin users and 4.9 years for nonusers. The unadjusted crude incidence rate of HCC was 0.52 per 100 patient-years for all the patients in this analysis. When assessed alone, the statin group had a higher crude HCC incidence rate compared with the non-users (1.24 vs. 0.51; P < .001).

In an outcome analysis after propensity score weighting, statin users were found to have a 32% reduced risk of HCC (weighted subdistribution hazard ratio [SHR] = 0.68; 95% CI, 0.48-0.97) in the 2-year landmark cohort. However, overall mortality risk was similar between statin users and non-users (weighted SHR = 0.92; 95% CI, 0.76-1.11).

In a sensitivity analysis, patients who used nucleotide analogues (NA) with statins had an “additional 59% HCC risk reduction compared to NA users alone,” according to the research. When assessing other high-risk groups, researchers found that age greater than 50 years and male gender had a “lesser degree of HCC reduction benefit.” In addition, researchers saw a trend toward a reduced risk for HCC among patients with diabetes mellitus (weighted SHR = 0.63; 95% CI, 0.38-1.04). 

The researchers concluded: “We have shown statin can provide 33 [to] 34% risk reduction in HCC development, but did not reduce mortality in HBV-infection population. The additive HCC risk reduction among the synergistic use of NA and statin merits further investigation in prospective trials.” – by Melinda Stevens

Disclosures: Hsiang reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.