Potential for Statins in the Chemoprevention and Management of Hepatocellular Carcinoma

Amedeo Lonardo; Paola Loria


J Gastroenterol Hepatol. 2012;27(11):1654-1664. 

In This Article

Which Statins Should Be Tested? Concerns for Safety of Statins in Patients With Chronic Liver Disease and Cirrhosis

Statins are remarkably hepato-safe agents.[55,68] Lewis et al. conducted a double-blind randomized controlled trial comparing high dose pravastatin (80 mg daily) to placebo in hypercholesterolemic adults with chronic liver disease.[82] These authors found that while being effective in lowering Total and LDL-cholesterol and triglycerides, pravstatin was not associated with primary pre-specified alanine aminotransferase (ALT) elevations.[82] No differences were registered as a function of the etiology of liver disease, or of the pre-treatment ALT values. In a more recent survey, adverse effects were similar across the statin types for each outcome except liver dysfunction where fluvastatin was associated with the highest risks.[83] This is consistent with the general rule that both the cholesterol-lowering activity and the incidence of aminotransferase elevations are tightly associated with the lipophilicity of ortho-substituents and meta-substituents on the aryl/biphenyl moiety.[55]