Eric R. Bates, MD
Is statin therapy safe in patients with preexisting liver disease?
Studies selected evaluated the safety of statins available in the US in patients with preexisting liver disease. Outcomes were elevations of alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels or liver function tests, and survival.
MEDLINE (Jun 2007), abstracts from major medical meetings, and references were searched for clinical trials, meta-analyses, and validation studies in English. 19 studies (n = 1563 receiving statins) met the selection criteria. Duration of follow-up ranged from 1 month to 6 years (median 9 mo).
Results are summarized in the Table.
Little high-quality evidence is available on the safety of statin use in patients with liver disease. No evidence exists that statins advance liver disease, and some evidence indicates that statins may improve liver disease or increase survival.
Safety of statin therapy in patients with preexisting liver disease*
*ALP = alkaline phosphatase; ALT = alanine aminotransferase; AST = aspartate aminotransferase; GGT = γ-glutamyl transferase; LFT = liver function test; RCT = randomized controlled trial; ULN = upper limit of normal.
Bates ER. Review: Limited evidence suggests that statins are safe in patients with liver disease. Ann Intern Med. 2008;149:JC2–12. doi: 10.7326/0003-4819-149-4-200808190-02012
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Published: Ann Intern Med. 2008;149(4):JC2-12.
Cardiology, Coronary Risk Factors, Dyslipidemia, Gastroenterology/Hepatology, Liver Disease.
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