Simvastatin is Efficacious in Treating Cirrhosis

Abstract

Background: Statins can improve prognosis of patients with liver cirrhosis by suppressing inflammation and lowering portal pressure.Here, we performed a meta-analysis to evaluate the clinical efficacy of simvastatin in liver cirrhosis patients.Methods: We searched PubMed, EMBASE, and Cochrane library databases for randomized controlled trials targeting simvastatin in patients with liver cirrhosis. The primary and secondary outcomes were the efficacy of simvastatin on clinical outcomes and its safety, respectively.Results: A total of 554 relevant articles were downloaded, of which 9 (comprising 648 participants) were eligible and were finally included in the analysis. Four studies revealed the impact of simvastatin on patient mortality, with the overall death rate found to be significantly lower in the simvastatin relative to the control group [risk ratio (RR): 0.46; 95% confidence interval (CI), 0.29 to 0.73; P < 0.01]. Further analysis of the cause of death showed that simvastatin significantly reduces incidence of fatal bleeding (RR: 0.35; 95% CI, 0.13 to 0.95; P = 0.04), as well as cholesterol [mean difference (MD): −31.48; 95% CI, −52.80 to −10.15; P < 0.01] and triglyceride (MD: −25.88; 95% CI, −49.90 to −1.86; P = 0.03) levels. At the same time, simvastatin did not significantly elevate levels of alanine aminotransferase (ALT) (MD: 2.34; 95% CI, −31.00 to 35.69; P = 0.89) and was not associated with incidence of other side effects.Conclusions: The use of simvastatin in cirrhotic patients lowers mortality rates by suppressing incidences of fatal bleeding.

Atorvastatin for patients with cirrhosis. A randomized, placebo-controlled trial

“…A meta-analysis of randomized controlled trials of simvastatin found lower mortality, concurring with a registry-based cohort study where simvastatin treatment lowered mortality by 8.0%–8.7% in patients with cirrhosis and Child-Pugh stages A and B. 37 , 38 Earlier studies showed its positive effects on hemodynamic and clinical end points, such as HVPG, survival rate, and decompensation events in long-term follow-up. 39 A recent study showed atorvastatin (20 mg/d) had a significant effect on HVPG when combined with propranolol, compared to propranolol alone, suggesting that combination therapies should be investigated further.…”

Alleviation Syndrome of High-Cholesterol-Diet-Induced Hypercholesterolemia in Mice by Intervention with Lactiplantibacillus plantarum WLPL21 via Regulation of Cholesterol Metabolism and Transportation as Well as Gut Microbiota

“…Plenty of factors (diet, weight, gender, age, exercise, and drinking) may affect the incidence and development of hypercholesterolemia [7][8][9][10][11]. The common treatment for ameliorating hypercholesterolemia includes drugs of statins, ezetimibe, proprotein convertase subtilisin/kexin type 9 (PCSK9), and peroxisome proliferatively activated receptor (PPARα) inhibitors, achieving a good effect; however, its side-effects (e.g., diarrhea, memory dysfunction, and diabetes risk) should not be neglected [12,13]. Therefore, exploring novel bioinoculants or probiotics to alleviate hypercholesterolemia is promising and should be a top priority for curbing CVDs.…”