Statins yield cancer survival gains in NAFLD patients

Among patients with nonalcoholic fatty liver disease (NAFLD), use of statins considerably reduces cancer-related mortality, a study has found.

The analysis included 10,821 NAFLD patients who participated in eight rounds of the National Health and Nutrition Examination Survey (NHANES). Mortality data were collected by linking the NHANES data to National Death Index.

Of the participants, 2,523 were statin users (23 percent). Multivariable Cox proportional hazards analysis revealed that compared with nonusers, users had a 43-percent lower risk of cancer mortality (hazard ratio [HR], 0.57, 95 percent confidence interval [CI], 0.43–0.75; p<0.001).

However, a shorter duration of use failed to confer a benefit. Specifically, less than 1 year of statin use showed no significant effect on cancer mortality (HR, 0.72, 95 percent CI, 0.46–1.12), whereas use for 1 to 5 years cut the outcome by 35 percent (HR, 0.65, 95 percent CI, 0.42–0.99; p=0.46) and for >5 years by 56 percent (HR, 0.44, 95 percent CI, 0.29–0.66; p<0.001).

The survival gain was evident in NAFLD patients at either low or high risk of liver fibrosis (HR, 0.55, 95 percent CI, 0.38–0.81 and HR, 0.53, 95 percent CI, 0.31–0.89, respectively).

Given that statin indications are prevalent among NAFLD patients, the present data may aid clinical decision making, as many patients do not receive benefit in the event that the statin is discontinued due to liver test abnormalities.