Saturday, November 12, 2016

AASLD 2016 Statins Shown to Reduce Risk of Death in People with Alcoholic Cirrhosis

Statins Shown to Reduce Risk of Death in People with Alcoholic Cirrhosis

BOSTON – The use of statins has been shown to significantly decrease risk of death among patients with alcoholic cirrhosis, according to research presented this week at The Liver Meeting® -- held by the American Association for the Study of Liver Diseases.

Alcoholic cirrhosis is an advanced form of liver disease, causing scarring of the liver. In many cases this is brought on by excessive alcohol consumption. In a mild degree of cirrhosis -- or compensated alcoholic cirrhosis -- the patient isn’t yet showing physical symptoms. In decompensated cirrhosis, their livers have sustained life-threatening damage, and patients are showing symptoms such a jaundice, internal bleeding, fluid retention and confusion.

“Current medical treatment has only little effect on the severely reduced life expectancy among patients with decompensated cirrhosis,” explains Ulrich Christian Bang, MD, PhD; Gastrounit, University Hospital of Hvidovre, Copenhagen, Denmark, and lead investigator in the study. “Ultimately a liver transplantation may be the only treatment, but transplantation is suitable only for very few patients and it is important to find new medical approaches that all patients with cirrhosis may benefit from.”

To address this, Dr. Bang’s team used the Danish Nationwide Databases to identify patients with alcoholic cirrhosis (noted by ICD-10 code) who had filled prescriptions for statins from Danish pharmacies to determine if use of statins has any effect on their clinical outcomes.

Dr. Bang’s team used this database to identify 17,424 patients (the original cohort of patients) diagnosed with alcoholic cirrhosis (based on ICD-10 codes) between the years of 1995 and 2010.The average age was 56 years and the patients were divided based on whether they had compensated (10,339 patients) or decompensated -- marked by a history of internal bleeding, banding procedure or paracentesis -- cirrhosis (7,085 patients). Statins were used by 7.1 percent of patients with compensated and 5.7 percent with decompensated cirrhosis during the time period studied. Simvastatin was by far the most popular statin followed by atorvastatin.

Next, the patients taking statins were each matched with four patients from the original cohort who were not taking statins. This new group (called the matched cohort) was comprised of 2,305 patients with compensated and 1,225 patients with decompensated cirrhosis.

During follow up time, 48 percent of patients with compensated, and 50 percent of patients with decompensated died with mortality rates of 172 and 218 deaths per 1,000 person-years, respectively. In the matched cohort Dr. Bang’s team found that use of statins was related with a 55 percent reduction in mortality among patients with compensated cirrhosis and a 40 percent reduce in mortality among patients with decompensated cirrhosis.

“This study -- along with other similar studies -- strongly supports the hypothesis that these patients may benefit from statins, and a randomized study with placebo is the next natural step in the investigation of statins and cirrhosis,” Dr. Bang explains of these findings.

Dr. Bang will present these findings at AASLD’s press conference in Room 313 at John B. Hynes Veterans Memorial Convention Center in Boston on Saturday, November 12 at 4pm. Dr. Bang will present the study entitled “The impact of statins on mortality in patients with compensated or decompensated alcoholic cirrhosis in a nationwide retrospective study” on Monday, November 14 at 5:45pm in Room 302/304. The corresponding abstract (number 251) can be found in the journal, Hepatology – Special Issue: The 67th Annual Meeting of the American Association for the Study of Liver Diseases: The Liver Meeting 2016.

About the AASLD

AASLD is a medical subspecialty society representing clinicians and researchers in liver disease. The work of our members has laid the foundation for the development of drugs used to treat patients with viral hepatitis. Access to care and support of liver disease research are at the center of AASLD’s advocacy efforts.

AASLD is the leading organization of scientists and healthcare professionals committed to preventing and curing liver disease. AASLD was founded in 1950 by a small group of leading liver specialists and has grown to an international society responsible for all aspects of hepatology.

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