Cirrhosis as new indication for statins

Gut. 2020 May;69(5):953-962. doi: 10.1136/gutjnl-2019-318237. Epub 2020 Mar 5.

Abstract

In the recent years, there have been an increasing number of reports on favourable effects of statins in patients with advanced chronic liver disease. These include reduction in portal pressure, improved liver sinusoidal endothelial and hepatic microvascular dysfunction, decreased fibrogenesis, protection against ischaemia/reperfusion injury, safe prolongation of ex vivo liver graft preservation, reduced sensitivity to endotoxin-mediated liver damage, protection from acute-on-chronic liver failure, prevention of liver injury following hypovolaemic shock and preventing/delaying progression of cirrhosis of any aetiology. Moreover, statins have been shown to have potential beneficial effects in the progression of other liver diseases, such as chronic sclerosing cholangitis and in preventing hepatocellular carcinoma. Because of these many theoretically favourable effects, statins have evolved from being considered a risk to kind of wonder drugs for patients with chronic liver diseases. The present article reviews the current knowledge on the potential applications of statins in chronic liver diseases, from its mechanistic background to objective evidence from clinical studies.

Keywords: endothelial cells; fibrosis; non-alcoholic steatohepatitis; portal hypertension.

Publication types

  • Review

MeSH terms

  • Biopsy, Needle
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / prevention & control*
  • Disease Progression
  • Female
  • Graft Rejection / drug therapy
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Immunohistochemistry
  • Liver Cirrhosis / drug therapy*
  • Liver Cirrhosis / pathology
  • Liver Failure / prevention & control*
  • Liver Neoplasms / prevention & control
  • Liver Neoplasms / surgery*
  • Liver Transplantation / methods
  • Male
  • Portal Pressure / drug effects
  • Severity of Illness Index

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors