Use of Statins in Patients with Chronic Liver Disease and Cirrhosis: Current Views and Prospects

Abstract

Purpose of review: The purpose of this study is to analyze the current evidence regarding the use of statins in patients with chronic liver disease and cirrhosis.

Recent findings: Chronic liver disease (CLD), cirrhosis, and its complications, including hepatocellular carcinoma (HCC), are significant public health problems. The use of statins in patients with CLD has been a matter of concern, and physicians are often reluctant to its prescription in these patients. This mainly relates to the potential occurrence of drug-induced liver injury. However, newer evidence from pre-clinical and clinical research has shown that statins are drugs with a potentially beneficial impact on the natural history of cirrhosis, on portal hypertension, and in HCC prevention. In this review, we summarize current evidence regarding the influence of statins in endothelial dysfunction in CLD, their ability to modulate hepatic fibrogenesis, and their vasoprotective effects in portal hypertension; we also focus on existing data about the impact of statins in cirrhosis development, progression, and complications and critically assess the current concerns about its use in patients with CLD.

Keywords: Chronic liver diseases; Cirrhosis; Drug-induced liver injury; HMG-CoA reductase inhibitors; Hepatocellular carcinoma; Portal hypertension; Statins; Variceal bleeding.

Fig. 1

Schematic representation of the evidence from translational research about the influence of statins in endothelial dysfunction in CLD, modulation of mechanisms of activation of fibrogenesis, and effects in portal hypertension. eNOS nitric oxide synthase, NO nitric oxide, CNP C-type natriuretic peptide, ET-1 endothelin-1, NASH non-alcoholic steatohepatitis, PPAR-γ peroxisome proliferator-activated receptor gamma