Statin Use Linked to Reduced Liver Complications in Primary Biliary Cholangitis: Study
A new study published in the journal of Hepatology showed that statin usage was linked to decreased risks of significant liver-related events and hepatic decompensation in patients with primary biliary cholangitis (PBC), indicating possible preventive advantages beyond lipid reduction.
According to recent research, individuals with PBC who take statins had a lower risk of hepatic decompensation. Statins may have pleiotropic benefits beyond decreasing cholesterol, including as anti-inflammatory and antifibrotic effects inside the liver, even though PBC is a chronic cholestatic illness that can result in cirrhosis. There is evidence that patients exposed to statins had reduced incidences of encephalopathy, ascites, and variceal hemorrhage.
Considering the elevated cardiovascular risk profile in PBC patients, this benefit is very noteworthy. Hepatotoxicity concerns, however, still exist and need for close observation. As per newly available data, statin therapy may help lower liver-related problems in PBC by improving endothelial function and reducing inflammation. All things considered, statins seem to be a useful supplemental treatment for enhancing long-term liver results. Thus, this study used a target trial emulation (TTE) strategy to evaluate the relationship between statin usage and the risk of hepatic decompensation.
Two electronic health record databases—Mass General Brigham (MGB, Boston, USA) and Asan Medical Center (AMC, Seoul, Korea)—were used to conduct a sequential TTE. Eligible adults had a PBC diagnosis between 2001 and 2024. A cumulative length of ≥90 days was used to determine statin usage. Propensity score matching was used to match statin initiators to non-users 1:2 in each monthly experiment. Hepatic decompensation was the main event, while a composite major adverse liver outcome (MALO) including liver transplantation, hepatocellular cancer, and decompensation was the secondary outcome.
443 statin users and 886 non-users were matched among 2,889 eligible individuals. Hepatic decompensation occurred in 24 statin users (5.4%) and 67 non-users (7.6%) with a median follow-up of 3.8 years (hazard ratio [HR], 0.61; 95% CI]: 0.38–0.97). A lower incidence of MALO was also linked to statin usage (HR, 0.58; 95% CI: 0.38–0.89).
Similar directional patterns were seen in sensitivity analyses stratified by cirrhosis status (HR 0.70 for cirrhosis; HR 0.57 for without) and data source (MGB, HR 0.65; AMC, HR 0.60). Overall, in individuals with PBC, statin treatment was consistently linked to a decreased incidence of severe liver events and hepatic decompensation, suggesting a possible protective impact.
Source:
Choi, J., Xu, J., Nguyen, V. H., Przybyszewski, E., Pratt, D. S., Song, J., Carroll, A., Michta, M., Almazan, E., Simon, T. G., & Chung, R. T. (2026). Association between statin use and hepatic decompensation in patients with primary biliary cholangitis: A target trial emulation study. Hepatology (Baltimore, Md.). https://doi.org/10.1097/HEP.0000000000001701
