Statins reduce hepatocellular carcinoma risk in cirrhotic patients

The risk of hepatocellular carcinoma (HCC) among patients with nonalcoholic steatohepatitis (NASH) and bridging fibrosis is low, reveals a recent study. In addition, dose-dependent statin can substantially lower the risk of HCC in patients with NASH cirrhosis.

A retrospective study was conducted at two US tertiary academic centre, which included patients with NASH-related advanced liver fibrosis (bridging fibrosis [F3] and cirrhosis) followed between July 2002 and June 2016.

The authors followed patients from the data of diagnosis to the time of last abdominal imaging, liver transplantation, or HCC diagnosis. They also performed multivariable Cox regression analysis to assess the risk factors associated with HCC development, stratified by fibrosis stage.

Of the 1,072 patients included in the analysis, 122 had F3 fibrosis and 950 cirrhosis. No HCC was observed among F3 patients during 602 person-years of follow-up. Among those with cirrhosis, HCC developed in 82 patients, with an annual incidence rate of 1.90 per 100 person-years (95 percent confidence interval [CI], 1.53–2.35).

On multivariable analysis, HCC development in patients with cirrhosis correlated with male sex (hazard ratio [HR], 4.06, 95 percent CI, 2.54–6.51; p<0.001), older age (HR, 1.05, 95 percent CI, 1.03–1.08; p<0.001), and Child-Turcotte-Pugh score (HR, 1.38, 95 percent CI, 1.18–1.60; p<0.001).

Notably, statin use resulted in a lower risk of developing HCC (HR, 0.40, 95 percent CI, 0.24–0.67; p=0.001). Each 365 increment in cumulative defined daily dose of statin use reduced the risk of HCC by 23.6 percent.