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Curr Treat Options Gastroenterol. 2018 Jun;16(2):226-240. doi: 10.1007/s11938-018-0180-4.

The Use of Statins in Patients With Chronic Liver Disease and Cirrhosis.

Author information

1
Division of Gastroenterology and Liver Unit, University of Alberta, 8540 112 Street NW, Zeidler Ledcor Centre, Room 1-20B, Edmonton, Alberta, T6G 2X8, Canada.
2
Division of Gastroenterology and Liver Unit, University of Alberta, 8540 112 Street NW, Zeidler Ledcor Centre, Room 1-20B, Edmonton, Alberta, T6G 2X8, Canada. aldo.montano-loza@ualberta.ca.

Abstract

PURPOSE OF REVIEW:

Statins are drugs developed to treat hypercholesterolemia. Its use in patients with liver disease has been limited because one of its potential and most feared side effects is hepatotoxicity. However, there is robust evidence that supports the safety of statins in this population in the absence of severe liver dysfunction. In this review, we will summarize the efficacy and safety of statins in cirrhosis.

RECENT FINDINGS:

Statins are effective in the treatment of dyslipidemia in patients with liver disease, because of their pleiotropic properties. These properties are independent of their effect on cholesterol levels, such as improving endothelial dysfunction or having antioxidant, antifibrotic, anti-inflammatory, antiproliferative, antiangiogenic, proapoptotic, or immunomodulation properties. Statins have been studied in other areas such as in treatment of portal hypertension, prevention of hepatocellular carcinoma, and/or protection against ischemia/reperfusion injury. Approved indications for statins in patients with cirrhosis are those of the general population, including dyslipidemia and increased cardiovascular risk. Compensated cirrhosis is not a contraindication. In patients with decompensated cirrhosis, statins should be prescribed with extreme caution at low doses, and with frequent monitoring of creatinine phosphokinase levels in order to detect adverse events in a timely fashion.

KEYWORDS:

Chemical- and drug-induced liver injury; Dyslipidemias; End-stage liver disease; Hydroxymethylglutaryl-CoA reductase inhibitors; Hypertension, portal; Liver cirrhosis

PMID:
29572618
DOI:
10.1007/s11938-018-0180-4

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