Safety of Chronic Simvastatin Treatment in Patients with Decompensated Cirrhosis: Many Adverse Events but No Liver Injury
| Autor: | Alberto E. Muñoz, Gustavo Romero, Florencia D Pollarsky, Daniel Álvarez, Pablo A Salgado, Mariano Cartier, M. Marino, Horacio Vázquez, Carlos Míguez |
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| Rok vydání: | 2020 |
| Předmět: |
Liver injury
medicine.medical_specialty Cirrhosis Physiology business.industry Mortality rate Standard treatment Gastroenterology Hepatology medicine.disease 03 medical and health sciences Liver disease 0302 clinical medicine Simvastatin 030220 oncology & carcinogenesis Internal medicine medicine 030211 gastroenterology & hepatology Adverse effect business medicine.drug |
| Zdroj: | Digestive Diseases and Sciences. 66:3199-3208 |
| ISSN: | 1573-2568 0163-2116 |
| DOI: | 10.1007/s10620-020-06630-7 |
| Popis: | The high mortality rate of decompensated cirrhosis underlines the need for new treatments. Experimental models of cirrhosis and its reported relationship with atherosclerotic cardiovascular disease have provided data supporting the rational use of statins in these patients. However, little is known about the safety of statins in this setting. We evaluate the safety of chronic simvastatin treatment in patients with decompensated cirrhosis. We conducted a prospective, open, uncontrolled, phase 2a trial in 30 patients with Child–Pugh class A (n = 6), B (n = 22), and C (n = 2) decompensated cirrhosis. The patients received standard treatment throughout the trial plus simvastatin 20 mg/day for 2 weeks and thereafter simvastatin 40 mg/day up to 1 year. Sixteen out of 30 patients (53.3%) showed adverse events, including gastrointestinal toxicity (36.7%), muscle injury (MI) (36.7%), and headache (13.3%). No liver injury was registered. Due to MI alone, simvastatin dosage was reduced in 23.4% of cases and transiently interrupted in 13.3%. Once these adverse events were overcome, simvastatin was resumed until the end of the trial. MI was associated with baseline MELD score > 12 (p = 0.035) and with baseline Child–Pugh class C. No MI was associated with final Child–Pugh score ≤ 6 (p = 0.030) or final Child–Pugh class A (p = 0.020). Chronic treatment with simvastatin 40 mg/day in patients with decompensated cirrhosis was associated with several adverse events, being MI the only clinically significant one, which appears to be related to the simvastatin dosage and the degree of cirrhosis severity. Noticeably, no liver injury was recorded. |
| Databáze: | OpenAIRE |
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