Statin drugs are widely used to manage high cholesterol and reduce the risk of cardiovascular disease. In a review of more than 50 studies, researchers at the University of Bonn cite reductions in liver inflammation and improvements in other related factors as reasons why statins make good candidates for treating chronic liver disease.
Reducing cholesterol can have a positive effect on many chronic liver disorders, including non-alcoholic fatty liver disease and non-alcoholic steatohepatitis, as well as in biliary disorders. In some studies, the research team found that statins reduced inflammatory molecules that are typically elevated with liver disease and improved inflammation in the endothelium (cells that line the blood vessels).
Statin use may also lead to: decreased fibrosis (hardening or scarring of tissue); less development of fatty liver; slowed or halted spread of hepatitis C virus; improvement of portal hypertension (high blood pressure in the liver’s blood vessels); destruction of existing liver tumor cells; and reduced risk of developing liver cancer.
The researchers acknowledge that statin drugs can contribute to liver damage in some people, but for people with advanced liver disease, “statins are cost-effective, generally well-tolerated by patients and the benefits of statin treatment in most patients outweigh their potential hepatotoxic risk.”
The evolution of chronic liver injuries from benign and manageable dysfunction to life threatening end stage liver disease with severe complications renders chronic liver disease a global health burden. Due to the lack of effective medication, transplantation remains the only and final curative option for end stage liver disease. Since the demand for organ transplants by far exceeds the supply, other treatment options are urgently required to prevent progression and improve end stage liver disease. Statins are primarily cholesterol-lowering drugs used for primary or secondary prevention of cardiovascular diseases. In addition to the primary effect, statins act beneficially through different pleiotropic mechanisms on inflammation, fibrosis, endothelial function, thrombosis and coagulation to improve chronic liver diseases. However, concerns remain about the efficacy and safety of statin treatment due to their potential hepatotoxic risks and as of now, these risks impede broader use of statins in the treatment of chronic liver diseases. The aim of this review is to comprehensively describe the mechanisms by which statins improve prospects for different chronic liver diseases with special focus on the pathophysiological rationale and the clinical experience of statin use in the treatment of liver diseases.
Robert Schierwagen, Frank Erhard Uschner, Fernando Magdaleno, Sabine Klein, Jonel Trebicka