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Statins may reduce mortality, decompensation in alcoholic cirrhosis

The use of statins in patients with alcoholic cirrhosis reduced the rates of both mortality and decompensation, according to recently published data.

“Our finding supports the hypothesis that statins may ameliorate the course of cirrhosis and decrease the rate of fibrosis,” U.C. Bang, MD, PhD, from the University Hospital of Hvidovre, Denmark, said in a press release. “The results are promising and we are looking forward to seeing whether prospective trials can verify the finding.”

To determine the relationship between statin use and the rates of mortality and decompensation in patients with alcoholic cirrhosis, the researchers gathered data from 1995 through 2014 from Danish registers. Patients with cancer, chronic hepatitis C and nonalcoholic fatty liver disease were excluded.

In the primary cohort of 5,417 patients with a healthy adherer profile (based on claims of opioid use and stability regarding dose of statins), researchers matched 744 for propensity score. They also analyzed a secondary cohort of 3,382 patients for decompensation, 375 of whom they matched for propensity score.

The mean mortality rate in the primary cohort was 96 per 1,000 person-years among patients who used statins compared with 121 per 1,000 person-years among those who did not (HR = 0.66; 95% CI, 0.59-0.75). In the matched cohort of 744, the mortality rate was 88 per 1,000 person-years for those who used statins vs. 127 per 1,000 person-years for those who did not (HR = 0.57; 95% CI, 0.45-0.71).

In the secondary cohort, the rate of decompensation was 135 per 1,000 person-years in patients who used statins compared with 361 per 1,000 person-years in those who did not (HR = 0.29; 95% CI, 0.24-0.34). In the matched group of 375, the rate of decompensation was 133 per 1,000 person-years among those who used statins and 234 per 1,000 person-years in those who did not (HR = 0.37; 95% CI, 0.27-0.5).

“In this retrospective study, we found that 15% of patients with alcoholic cirrhosis received statins at some point during their follow-up time,” Bang and colleagues wrote. “A possible mechanism behind the observed relationship between use of statins and mortality may be due to a lower risk of infections.”

In a sub-group analysis, researchers identified 387 patients with cirrhosis who had a stable median of 20 statin doses over three consecutive periods during follow-up. This group had a significantly reduced risk for mortality compared with 4,975 unmatched patients who did not use statins (HR = 0.8; 95% CI, 0.7-0.9).

“We were unable to demonstrate any clear association between the dose of statins and mortality although we did find a slightly increased risk of death for each increment in [daily dose per day] of statins when we used the moving average approach,” the researchers concluded. “We also found a lower mortality among patients with a higher likelihood of being in a period of stable statin dosing, which suggests that a constant in contrast to a changing exposure to statins has an effect on survival.” – by Talitha Bennett

Disclosure: The researchers report no relevant financial disclosures.