Statins may arrest Liver Fibrosis Progression in Patients with MASLD: BMJ

A recent study published in the BMJ Open Gastroenterology journal revealed a significant association between statin use and a reduced risk of liver fibrosis progression in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). This retrospective cohort study examined the electronic health records of patients with MASLD by offering insights into the protective effects of statins against liver fibrosis.

The study assessed the impact of statin therapy on the progression to high-risk advanced fibrosis in patients with MASLD. This study focused on patients who were initially categorized with a low or indeterminate risk for advanced fibrosis, as determined by a Fibrosis-4 Index (FIB-4) score of less than 2.67. The patients were monitored from their initial FIB-4 score until they either reached a high-risk FIB-4 score (≥2.67) or the until the study period concluded. The primary exposure of interest was whether the patients had been prescribed statins during the follow-up period.

The research employed Cox regression models to analyze the time it took for patients to progress to a high-risk FIB-4 score. These models accounted for various factors, including baseline fibrosis risk, demographic characteristics and comorbidities. The primary variable of interest was the presence of a statin prescription, while secondary analyses measured the intensity of statin use.

The study followed a cohort of 1,238 patients over an average period of 3.3 years. Among these patients, 47% received a statin prescription and 18% progressed to a high-risk FIB-4 score. The analysis revealed strong protective effect of statins against fibrosis progression. Also, patients prescribed statins had a 40% lower risk of advancing to a high-risk FIB-4 score when compared to those not on statin therapy.

When examining the intensity of statin use, the findings remained consistent. The patients on moderate-intensity statins showed a 40% reduction in risk, while the individuals on high-intensity statins expressed a 39% lower risk of fibrosis progression. This study highlights the potential benefits of statin therapy in managing liver fibrosis risk among the primary care patients with MASLD. Overall, the protective effect observed was significant across different intensities of statin use which suggests both moderate and high-intensity statins could be effective in reducing the progression to advanced liver fibrosis.

Source:

Schreiner, A. D., Zhang, J., Petz, C. A., Moran, W. P., Koch, D. G., Marsden, J., Bays, C., Mauldin, P. D., & Gebregziabher, M. (2024). Statin prescriptions and progression of advanced fibrosis risk in primary care patients with MASLD. In BMJ Open Gastroenterology (Vol. 11, Issue 1, p. e001404). BMJ. https://doi.org/10.1136/bmjgast-2024-001404