How Statin Type Influences HCC Incidence, Mortality in Those With Viral Hepatitis

Researchers recently compared how the use of lipophilic or hydrophilic statins impacted hepatocellular carcinoma (HCC) in patients with viral hepatitis. According to the research team, prior to the study, it was unknown whether statin type influenced HCC incidence or mortality in patients with chronic hepatitis B or C virus infection.

In order to “assess the relationship between lipophilic or hydrophilic statin use and HCC incidence and mortality in a nationwide population with viral hepatitis,” a team of researchers lead by Tracey G Simon, MD, MPH, Massachusetts General Hospital and Harvard Medical School, and colleagues, used a prospective propensity score-matched cohort. The cohort consisted of 16,668 adults of which 8334 initiated statin use and 8334 were nonusers. Of those on statins, 6554 received lipophilic statins and 1780 received hydrophilic statins. 

According to the study findings, 10-year HCC risk was significantly lower among lipophilic statin users but not hydrophilic statin users compared with matched nonusers. Notably, the researchers found that the inverse association between lipophilic statins and HCC risk was dose-dependent. Additional findings show that 10-year HCC risk was lowest with 600 or more lipophilic statin cumulative defined daily doses, and 10-year mortality was significantly lower among both lipophilic and hydrophilic statin users.  

“In a nationwide viral hepatitis cohort, lipophilic statins were associated with significantly reduced HCC incidence and mortality,” Dr Simon and colleagues concluded. “An association between hydrophilic statins and reduced risk for HCC was not found.” 

The researchers noted that further research is still needed to determine whether lipophilic statin therapy can be used for the prevention of HCC.  

—Julie Gould

Reference:

Simon TG, Duberg AS, Aleman S, et al. Lipophilic statins and risk or hepatocellular carcinoma and death in patients with chronic viral hepatitis: results from a nationwide Swedish population [published online August 20, 2019]. Ann Intern Med. 2019. doi: 10.7326/M18-2753