Comprehensive evaluation of effects and safety of statin on the progression of liver cirrhosis: a systematic review and meta-analysis.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968547 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-230X (Electronic) Linking ISSN: 1471230X NLM ISO Abbreviation: BMC Gastroenterol Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Hydroxymethylglutaryl-CoA Reductase Inhibitors/*pharmacology ; Liver Cirrhosis/*drug therapy; Ascites/prevention & control ; Carcinoma, Hepatocellular/prevention & control ; Disease Progression ; Dose-Response Relationship, Drug ; Esophageal and Gastric Varices/complications ; Gastrointestinal Hemorrhage/prevention & control ; Hepatic Encephalopathy/prevention & control ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects ; Liver Cirrhosis/mortality ; Liver Neoplasms/prevention & control ; Non-Randomized Controlled Trials as Topic ; Peritonitis/microbiology ; Peritonitis/prevention & control ; Portal Pressure/drug effects ; Publication Bias ; Randomized Controlled Trials as Topic

Background: Statin has been more and more widely used in chronic liver disease, however, existed studies have attained contradictory results. According to the present study, we aimed to test the efficacy and safety of statin via a meta-analysis.
Methods: Different databases were searched for full-text publication based on inclusion and exclusion criteria. For data-pooling, fixed-effect model was applied if heterogeneity wasn't detected. Otherwise, random-effect model was adopted. Heterogeneity was detected by I squire (I ² ) test. All results of analysis were illustrated as forest plots. Publication bias was assessed using the Begg's adjusted rank correlation test. Standard mean difference (SMD) was calculated in continuous variables. Pooled hazard ratio or odds ratio was calculated in catergorical variables.
Results: Seventeen clinical studies were finally included. Hepatic portal hemodynamic parameters were improved in statin users for a short-term response. For a long-term follow-up, statin treatment surprisingly decreased mortality rate (HR = 0.782, 95% CI: 0.718-0.846, I ²  > 50%) and lower the occurrence of hepatocellular carcinoma (HR = 0.75, 95% CI: 0.64-0.86, I ²  > 50%) in liver cirrhosis. Statin seemed not to decrease the risk of esophageal variceal bleeding and spontaneous bacterial peritonitis. However, statin was proved to decrease the risk of hepatic encephalopathy and ascites. Incidence of drug related adverse events didn't increase in statin users. Dose-dependent effects of statin on hepatocellular carcinoma development, decompensated cirrhosis events occurrence, and liver cirrhosis progression.
Conclusion: Statin influenced parameters of hepatic portal vessel pressure in short-term treatment. Prognosis of liver cirrhosis benefited from statin treatment in long term follow-up. The efficacy and safety of statin in liver cirrhosis treatment is confirmed. To date, similar study is hardly seen before.

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Keywords: Complication; Liver cirrhosis; Meta-analysis; Portal hypertension; Statin

0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)

Date Created: 20200101 Date Completed: 20200515 Latest Revision: 20200515

20231215

PMC6938024

10.1186/s12876-019-1147-1

31888534