Combination Therapy of Metformin and Statin May Decrease Hepatocellular Carcinoma Among Diabetic Patients in Asia

Abstract

Previous studies have shown that metformin or statins may decrease hepatocellular carcinoma (HCC) in diabetic patients. Accordingly, this article evaluates whether combination therapy may further reduce HCC.Newly diagnosed type 2 diabetes mellitus (DM) patients, excluding those with history of malignancy prior to the date of DM diagnosis, were recruited to a DM cohort. DM patients developed HCC as the cancer cohort and the date for HCC diagnosis as index date. Non-cancer cohort was frequency matched with 4:1 according to age, sex, DM-year, and index date as case group from DM cohort.Patients who were treated with statins showed a 63% decreased risk of HCC (odds ratio [OR] = 0.37; 95% confidence interval [CI] = 0.27–0.49). Patients who consumed simvastatin, atorvastatin, or rosuvastatin significantly decreased risk for HCC (OR = 0.32, 0.31, and 0.22; 95% CI = 0.18–0.58, 0.19–0.52, and 0.08–0.61, respectively). Metformin combinations with simvastatin, atorvastatin, or rosuvastatin may decrease HCC (OR = 0.30, 0.30, and 0.24; 95% CI = 0.15–0.59, 0.16–0.54, and 0.08–0.70, respectively). The comorbidities for HCC were decreased by consuming simvastatin and atorvastatin (OR = 0.31 and 0.29; 95% CI = 0.14–0.67 and 0.15–0.57, respectively). Only combination therapy of metformin and simvastatin may significantly decreased HCC comorbidities (OR = 0.26; 95% CI = 0.11–0.60) in our study.In Asia, not all metformin combinations with statins may reduce the incidence of HCC and not all of this kind of combination therapy may decrease the HCC comorbidities.

Statin Use and Cancer Incidence in Patients with Type 2 Diabetes Mellitus: A Network Meta-Analysis

“…Finally, seven studies reporting the effect of statins on type 2 diabetes mellitus patients were included in present analysis. Among the 7 studies enrolling a total of 23,555 participants, 2 studies are random control trials and 5 studies are case-control studies [ 34 – 40 ]. Table 1 shows the characteristics of study.…”

Meta-analysis of studies using statins as a reducer for primary liver cancer risk

“…Moreover, the shape of the dose–response relationship on this topic has not been described. Second, inverse 19 20 and null 15 18 21 22 23 associations with PLC risk have been reported for pravastatin, a commonly prescribed statin in clinical practice. This fact raises an issue of whether individual statin use is still associated with a reduced risk of PLC.…”

Cholesterol Lowering in Cancer Prevention and Therapy

“…Although cholesterol-lowering drugs have also been shown to possess an important antitumor activity that reduces cell growth, proliferation, and migration through ERK-mediated and Akt-mediated signaling pathways and is capable of inducing apoptosis through extrinsic and intrinsic pathways using different cancer cells as models [43-45, 75, 78, 104, 118-123], it is still unclear whether statins are suitable to prevent the incidence of cancer. More than a hundred of epidemiological studies around the world have been performed to evaluate the effect of statin on the risk of cancer incidence [105,108,109,[126][127][128][129][130][131][132][133][134][135][136][137][138][139][140][141][142]. These studies have been focused on statin type, potency, lipophilic or hydrophobicity status, and duration of use.…”