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By Tabitha Reuben: Researchers from University College London have claimed that Statins are safe and effective for patients with liver enzyme abnormalities and they also improve the function of the liver in these patients. Dimitri P. Mikhailidis, MD, of University College London, and colleagues said in their study that liver test results in patients with moderately abnormal liver tests at baseline improved with statin treatment. "The risk-to-benefit ratio of long-term statin treatment favors statin administration even for patients with moderately abnormal liver tests," the authors wrote.
Mikhailidis and colleagues conducted a post hoc analysis of the Greek Atorvastatin and Coronary Heart Disease Evaluation (GREACE) study to find whether long-term statin treatment (mainly atorvastatin) is safe and effective in patients having NAFLD.
Ted Bader, MD, of the University of Oklahoma Health Sciences Center in Oklahoma City wrote in Lancet, "Statin-induced hepatotoxicity is a myth," he wrote in Lancet. Bader stressed that liver enzymes rise after starting a statin in about 10% of patients. He said that it can exceed the threshold of three times the upper limit of normal for 1%, but the limit then return to normal even when the patients continue the same statin.
"Despite the absence of liver injury from statins, a US survey showed that 50% of academic physicians would be reluctant to give a statin to a patient with an ALT of more than 1.5 times the upper limit of normal…10% to 30% of patients who need statins…would therefore be denied a statin," he said. "Most physicians believe that statins cause liver disease because of the language of package inserts. Drug companies should be encouraged to request the deletion of this point from the insert."
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