Researchers from the Karolinska Institutet, Stockholm, Sweden and Harvard University, Boston, US have discovered through a study that lipophilic statins were associated with significantly reduced hepatocellular carcinoma (HCC) incidence and mortality.
Approximately 1.5 million cases of HCC are diagnosed worldwide each year, related primarily to chronic infection with hepatitis B virus or hepatitis C virus. In the U.S. and Europe, incidence of HCC has tripled since the 1970s and mortality is increasing more rapidly for HCC than for any other cancer. As such, there is an urgent need to identify effective primary prevention strategies.
The results from the study suggest that lipophilic statins (atorvastatin, simvastatin, fluvastatin, and lovastatin) may prevent hepatocarcinogenesis more effectively than hydrophilic statins (pravastatin or rosuvastatin)
The researchers studied a nationwide Swedish registry of adults with viral hepatitis B or C to assess the relationship between lipophilic or hydrophilic statin use and HCC incidence and mortality. Compared with a matched cohort that did not use statins, lipophilic statin use was associated with substantially lower risk for incident HCC, all-cause death, and liver-related death.
The apparent benefits of lipophilic statins were dose and duration-dependent, with the greatest reduction in HCC risk occurring after at least 600 cumulative defined daily doses (the equivalent of taking a moderate-dose statin for approximately 24 months). A similar association with reduced HCC risk was not found with hydrophilic statin use. According to the researchers, these findings confirm prior data linking statins with improved survival and reduced HCC risk in chronic liver disease.
Further studies are underway to determine whether lipophilic statin therapy is feasible for prevention of HCC and should be advocated as a preventive measure or protocol.
Reference: Tracey G. Simon et al. Lipophilic Statins and Risk for Hepatocellular Carcinoma and Death in Patients With Chronic Viral Hepatitis: Results From a Nationwide Swedish Population, Annals of Internal Medicine (2019). DOI: 10.7326/M18-2753