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

Abstract

A protective effect of statins on primary liver cancer (PLC) risk has been suggested. However, issues about the dose–response relationship, the protective effect of individual statins, and PLC risk reduction among at-risk populations remain unsolved. Therefore, a meta-analysis was conducted. PubMed and EMBASE were searched for studies providing the risk ratio (RR) on statins and PLC risk. Summary RRs were calculated using a random-effects model. Twenty-five studies were identified. Stain use was significantly associated with a reduced risk of PLC (RR = 0.60, 95% confidence interval (CI) = 0.53–0.69). The summary RR for every additional 50 cumulative defined daily doses per year was 0.87 (95% CI = 0.83–0.91). Evidence of a non-linear dose–response relationship between statins and PLC risk was found (Pnon-linearity < 0.01). All individual statins significantly reduced PLC risk, and the risk reduction was more evident with rosuvastatin. The inverse association between statins and PLC risk remained among populations with common risk factors. Subgroup analyses revealed more significant reduction in PLC risk by statins in high- versus non-high-risk populations (Pinteraction = 0.02). Overall, these findings add to our understanding of the association between statins and PLC risk. Whether statin use is causally associated with a reduced risk of PLC should be further studied.

The role of statins as therapeutic agents in cancer

“…Statins may have a role in colorectal cancer chemoprevention by acting at the later stages of progression rather than at the early stages of adenoma initiation and development in the adenoma-carcinoma sequence (Jung et al 2016). A protective effect of statins on primary liver cancer (PLC) was observed, most notably of rosuvastatin (Zhong et al 2016). This protective effect is more pronounced in high-risk populations, is dose-dependent, and persisted in patients with diabetes, hepatitis B or C virus infection.…”

“…These findings support the suggestion that statins can serve as chemopreventive agents of PLC and reduce the public health burden of this malignancy. Prospective cohort studies with sufficient follow-up duration and large sample size are warranted to address this issue before formally recommending statins in preventing PLC (Zhong et al 2016). Liu et al have shown that lovastatin and fluvastatin did not significantly reduce the lung cancer risk in patients with chronic obstructive pulmonary disease (COPD) .…”

Hepatotoxicity associated with statins

“…They concluded that the use of statins decreased the risk of primary liver cancer. Notably, the protective effects of rosuvastatin were higher than those of the other statins (43).…”

“…Simvastatin is metabolised primarily by CYP3A4, when it is used concomitantly with amiodarone, which is an inhibitor of CYP3A4 enzyme; and interaction between these two drugs (simvastatin and amiodarone) increases hepatotoxicity (42). Another study, meta-analysis was carried out by Zhong et al (43). They investigated the protective effects of statins relative to the risk of primary liver cancer.…”

Prospects of the statin treatment: Review of current studies

“…Розувастатин и аторвастатин (но не другие статины) снижают уровень мочевой кислоты сыворотки крови [39]. Есть данные о том, что применение статинов снижает риск гепатоцел-люлярной карциномы [40,41]. Sahebkar с соавт.…”