Statins can prevent liver cancer

Chronic viral hepatitis (hepatitis B and C) are severe conditions with an increased risk of liver cancer. Currently, it is possible to treat hepatitis B and cure hepatitis C but there is no treatment that can prevent liver cancer in people whose liver has been damaged by hepatitis.

In recent years, researchers have begun to investigate whether statins, which lower cholesterol levels and are primarily used to prevent cardiovascular disease, can also prevent liver cancer. Statins are either fat-soluble (lipophilic) or water-soluble (hydrophilic), but the role that this difference plays for potentially preventing cancer has been unclear.

In the study in question, more than 63,000 patients with chronic hepatitis B and C were identified. Among these, 8,334 patients used statins, of which 6,554 used fat-soluble statins (e.g. atorvastatin, simvastatin, fluvastatin, lovastatin) and 1,780 used water-soluble statins (e.g. pravastatin, rosuvastatin).

During a 10-year follow-up period, liver cancer developed in 3.3 per cent of the patients with fat-soluble statins compared with 8.1 per cent of the patients without statins. After other factors were taken into account, this corresponded to a 44 per cent lower risk of liver cancer. Patients with fat-soluble statins also had a lower mortality rate after ten years than patients who had never used statins.

”Previous research has indicated that statins may play a role in preventing liver cancer. Now we have confirmed that and shown that it is the fat-soluble statins that have the greatest effect,” says Jonas F. Ludvigsson, Professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.

The patients who used water-soluble statins also had a lower mortality rate but did not have a reduced incidence of liver cancer. In addition, fat-soluble statins had a greater effect on mortality than water-soluble statins had. The research group is now going to study whether fat-soluble statins can affect the risk of liver cancer and mortality in conjunction with other types of liver disease as well.

The study was funded by the American College of Gastroenterology, Stockholm Region, and Region Örebro län. Co-authors Soo Aleman and Ann-Sofi Duberg have had paid lecture and consultancy assignments for the companies AbbVie, BMS, Gilead, Janssen, MSD, and Soo Aleman has received research funding from AbbVie and Gilead. Raymond Chung has received research funding for his department from Gilead, Abbvie, Merck, Janssen, Boehringer Ingelheim, Roche, Synlogic and Kaleido. Jonas F Ludvigsson is coordinating a study for the Swedish IBD quality register (SWIBREG), a study funded by Janssen.

Publication: ”Lipophilic Statins and Risk of Hepatocellular Carcinoma and Mortality in Patients with Chronic Viral Hepatitis: Results from A Nationwide Swedish Population”. Tracey G. Simon, Ann-Sofi Duberg, Soo Aleman, Hannes Hagstrom, Long H. Nguyen, Hamed Khalili, Raymond T. Chung, Jonas F. Ludvigsson. Annals of Internal Medicine, online 19 August 2019, doi: 10.7326/M18-2753.