Change in ALT levels after administration of HMG‐CoA reductase inhibitors to subjects with pretreatment levels three times the upper normal limit in clinical practice

Abstract

It is not clear whether it is safe to prescribe statins to patients with ALT > 3 times the UNL. Our study showed that prescription of statins in combination with HEPA did not cause deleterious effects, suggesting that ALT levels > 3 times the UNL do not have harmful effects.

Statins and substantially increased ALT values at baseline

“…Most of the patients with >3 × UNL ALT activity before statin treatment are expected to have nonalcoholic fatty liver disease (NAFLD). 1 The conclusion is that statin use did not cause severe liver damage in these patients. In fact, most participants on statins showed improvement or maintenance of their ALT levels.…”

“…In fact, most participants on statins showed improvement or maintenance of their ALT levels. 1 However, this study had several limitations, as outlined by the authors. 1 The Kim et al 1 findings are supported by those of a multicenter study that included a cohort of 1201 European individuals (107 participants on statins; 100 matched for several characteristics), who underwent liver biopsy for suspected nonalcoholic steatohepatitis (NASH).…”

“…1 However, this study had several limitations, as outlined by the authors. 1 The Kim et al 1 findings are supported by those of a multicenter study that included a cohort of 1201 European individuals (107 participants on statins; 100 matched for several characteristics), who underwent liver biopsy for suspected nonalcoholic steatohepatitis (NASH). 2 Statin use was associated with protection from the full spectrum of liver damage.…”

Decision-Making in Artificial Intelligence: Is It Always Correct?

“…6-8 Of course, when observed more closely, there may be diagnoses that violate the guidelines and treatments that are incorrect according to the protocol. 9 However, do physicians apply incorrect treatments because they do not know the proper guidelines and protocols? When physicians make medical decisions in an actual hospital setting, ethical or medical principles that are not included in data-based guidelines and protocols come into play.…”

“…Even if it does not follow the guidelines of a textbook, diverse diagnoses and less-effective treatments can be attempted when deemed necessary, as long as they are subject to strict monitoring. 9 Treatment may be postponed due to the patient's financial situation. Depending on the patient's will to live, a physician may attempt impossible or less successful treatments.…”