Statin use and the risk of hepatocellular carcinoma among patients with chronic hepatitis B: an emulated target trial using longitudinal nationwide population cohort dataopen access
- Authors
- Sinn, Dong Hyun; Kang, Danbee; Park, Yewan; Kim, Hyunsoo; Hong, Yun Soo; Cho, Juhee; Gwak, Geum-Youn
- Issue Date
- 25-Oct-2023
- Publisher
- BMC
- Keywords
- Chronic Hepatitis B; Hepatocellular carcinoma; Statin
- Citation
- BMC GASTROENTEROLOGY, v.23, no.1
- Indexed
- SCIE
SCOPUS
- Journal Title
- BMC GASTROENTEROLOGY
- Volume
- 23
- Number
- 1
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/109321
- DOI
- 10.1186/s12876-023-02996-w
- ISSN
- 1471-230X
1471-230X
- Abstract
- BackgroundNo randomized controlled trials have been completed to see whether statin can decrease hepatocellular carcinoma (HCC) risk in chronic hepatitis B (CHB) patients. We used large-scale, population-based, observational data to emulate a target trial with two groups, statin user and statin non-user.MethodsAmong 1,379,708 nonunique individuals from the Korean National Health Insurance Service data, 2,915 CHB patients with serum cholesterol level of 200 mg/dL or higher who started statin therapy and 8,525 propensity-score matched CHB patients with serum cholesterol level of 200 mg/dL or higher who did not start statin therapy were analyzed for the development of HCC. In addition, liver cancer or liver-related mortality and all-cause mortality were assessed.ResultsDuring follow-up, 207 participants developed HCC. Incidence rate of HCC was 0.2 per 1,000 person-years in the statin user group and 0.3 per 1,000 person-years in the statin non-user group. Fully adjusted hazard ratio (HR) for incident HCC comparing statin user group to statin nonuser group was 0.56 (95% confidence interval [CI]: 0.39 to 0.80). The association between statin use and decreased HCC risk was consistent in all subgroups analyzed. Fully adjusted HR comparing statin user to statin nonuser was 0.59 (95% CI: 0.35 to 0.99) for liver cancer or liver-related mortality and 0.93 (95% CI: 0.78 to 1.11) for all-cause mortality.ConclusionsStatin might have a benefit for preventing HCC in CHB patients with elevated cholesterol levels. Statin should be actively considered for CHB patients with dyslipidemia.
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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