Table 2.
Clinical studies investigating the effects of statin use on population at risk of hepatocellular carcinoma
| Study | Study design | Data source | Liver disease etiology | Cirrhosis | Total patients* (users/non-users) | HCC | Statin type | Definition of statin users | Follow-up (years) | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|
| Tsan et al. [32] (2012) | Retrospective cohort study | Taiwan National Health Insurance Research Database | HBV | 10.7% | 33,413 (2,785/30,628) | 1,021 | A, F, L, S, P, R | ≥28 cDDDs | 9.8 | aHR, 0.47 (95% CI, 0.36–0.61) |
| Chen et al. [89] (2015) | Retrospective cohort study | Taiwan Longitudinal Health Insurance Database 2000 | HBV | NR | 71,824 (8,861/53,037) | 1,735 | NR | ≥28 cDDDs | NR | aHR, 0.34 (95% CI, 0.27–0.42) |
| Hsiang et al. [35] (2015) | Retrospective cohort study | University hospital | HBV | 3.1% | 53,513 (1,176/52,337) | 6,883 | A, F, S, R | 2-year exposure | 4.6 | aHR, 0.68 (95% CI, 0.48–0.97) |
| Goh et al. [34] (2020) | Retrospective cohort study | University hospital | HBV | 24.1% | 7,713 (713/7,000) | 702 | A, F, S, P, Pi, R | ≥28 cDDDs | 9.2 | aHR, 0.36 (95% CI, 0.19–0.68) |
| Tsan et al. [33] (2013) | Retrospective cohort study | Taiwan National Health Insurance Research Database | HCV | 18.4% | 260,864 (35,023/225,841) | 27,883 | A, F, L, S, P, R | ≥28 cDDDs | 10.7 | aHR, 0.53 (95% CI, 0.49–0.58) |
| Butt et al. [36] (2015) | Retrospective cohort study | Electronically Retrieved Cohort of HCV Infected Veterans | HCV | 0.0% | 7,248 (3,347/3,901) | 142 | NR | ≥28 cDDDs | 10.0 | aHR, 0.51 (95% CI, 0.34–0.76) |
| Simon et al. [90] (2016) | Retrospective cohort study | Electronically Retrieved Cohort of HCV Infected Veterans | HCV | 0.0% | 9,135 (4,165/4,970) | 239 | A, C, F, L, S, P, R | >28 cDDDs | 7.4 | aHR, 0.51 (95% CI, 0.36–0.72) |
| Mohanty et al. [91] (2016) | Retrospective cohort study | US Veteran Affairs Clinical Case Registry | HCV | 100% | 1,370 (685/685) | 173 | F, L, S, P, R | ≥2 filled prescription | 2.5 | aHR, 0.42 (95% CI, 0.27–0.64) |
| Simon et al. [44] (2019) | Prospective cohort study | Nationwide Swedish registry | HBV, HCV | 10.7% | 16,668 (8,334/8,334) | 616 | A, S, P, R | ≥30 cDDDs | 8.0 | Lipophilic statin use: aHR, 0.56 (95% CI, 0.41–0.79) |
| Hydrophilic statin: aHR, 0.95 (95% CI, 0.86–1.08) | ||||||||||
| German et al. [92] (2020) | Case-control study | University hospital | NAFLD | 91.2% | 102 (40/62) | 34 | NR | NR | NR | aOR, 0.20 (95% CI, 0.07–0.60) |
| Pinyopornpanish et al. [37] (2021) | Retrospective cohort study | University hospitals | NASH (F3, F4) | F3/F4: 100% | 1,072 (440/532) | 82 | A, S, L, Pi, P, R | ≥28 cDDDs | 4.6 | aHR, 0.40 (95% CI, 0.24–0.67) |
HCC, hepatocellular carcinoma; HBV, hepatitis B virus; A, atorvastatin; F, fluvastatin; L, lovastatin; S, simvastatin; P, pravastatin; R, rosuvastatin; cDDD, cumulative defined daily dose; aHR, adjusted hazard ratio; CI, confidence interval; NR, not reported; Pi, pitavastatin; HCV, hepatitis C virus; C, cerivastatin; NAFLD, nonalcoholic fatty liver disease; aOR, adjusted odds ratio; NASH, nonalcoholic steatohepatitis.
*
In the case of propensity score matching analysis, number of patients was estimated after matching.