The research supports continued statin treatment for patients with cardiovascular indications.
Statin therapy is associated with significantly lower risk for hepatocellular carcinoma (HCC), hepatic decompensation, and all-cause mortality among patients with chronic liver disease (CLD), according to study findings published inDigestive and Liver Disease
The evidence base about using stains in CLD is fragmented and conflicting, due to the heterogeneity among study populations and variation in statin agents and regimens across studies
To clarify the effect of statins in CLD, investigators searched publication databases through September 2025, finding a total of 17 systematic reviews with a corrected covered area (CCA) of 5.79%. These reviews considered 229 primary studies comprising a pooled study population of 10,515,877 patients residing in 34 countries
Use of statin therapy in CLD associated with a reduction in risk for HCC (hazard ratio [HR], 0.54; 95% CI, 0.49-0.59; I2=36.5%; P <.001), decompensation (HR, 0.54; 95% CI, 0.49-0.59; I2=0.1%; P <.001), and all-cause mortality (HR, 0.62; 95% CI, 0.51-0.77; I2=77.4%; P <.001)
Our results underscore the urgent need for adequately powered randomized trials … to clarify the boundaries of safety and efficacy in this high-risk population
In the subgroup analyses, a significant interaction was observed for HCC (P =.003), in which statin use better reduced HCC risk among Asian (HR, 0.49; 95% CI, 0.45-0.53; I²=0.0%) than Western (HR, 0.70; 95% CI, 0.54-0.89; I²=92.5%) populations
Leave-one-out, post-hoc sensitivity analyses, and/or restricted analyses indicated these trends were robust
The reported hepatotoxicity associated with statin use was generally low
Study limitations include the observational design
The study investigators concluded, “The coherence of observational associations across multiple independent research groups, combined with biological plausibility and an acceptable safety profile in compensated cirrhosis, supports the continued use of statins in patients with CLD where cardiovascular indications are present, with potential additive hepatoprotective benefit. […] Our results underscore the urgent need for adequately powered randomized trials —particularly the ongoing SACRED trial —mechanistic studies, and dedicated investigations in decompensated cirrhosis to clarify the boundaries of safety and efficacy in this high-risk population.”
Cattazzo F, Cinque F, Di Maria V, et al.Statins in chronic liver disease and its complications: An umbrella review and meta-analysis of systematic reviews.Dig Liver Dis. 2026;58(8):1027-1036. doi:10.1016/j.dld.2026.05.010
