親脂性他汀類藥物可減少肝細胞癌和慢性肝炎死亡

StephenW

Lipophilic Statins Decrease Hepatocellular Carcinoma and Death in Chronic Hepatitis
Virginia A. Schad, PharmD, RPh
Lipophilic statins may be associated with significantly reducing the incidence of hepatocellular carcinoma (HCC) and mortality, according to study results published in the Annals of Internal Medicine.

Approximately 500,000 cases of HCC are diagnosed worldwide each year, and data suggest that in chronic liver disease 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) may improve clinical outcomes and reduce HCC risk.  However, the influence of different statin classes on HCC risk and survival is unknown. Therefore, researchers assessed the relationship between lipophilic or hydrophilic statin use and HCC incidence and mortality in a nationwide population with viral hepatitis in Sweden.


Patients included a propensity score-matched cohort of 16,668 adults (8334 who initiated statin use [6554 lipophilic and 1780 hydrophilic] and 8334 nonusers) among 63,279 eligible adults (15,104 with hepatitis B virus infection and 48,175 with hepatitis C virus infection). Compared with nonusers, the 10-year HCC risk was significantly lower in lipophilic statin users (8.1% vs 3.3%) but not hydrophilic statin users (8.0% vs 6.8%). However, the inverse association between lipophilic statins and HCC risk seemed to be dose-dependent as the 10-year HCC risk was lowest with 600 or more lipophilic statin cumulative defined daily doses compared with nonusers (2.5% vs 8.4%). In addition, 10-year mortality was significantly lower in both lipophilic (7.3% vs 15.2%) and hydrophilic (11.5% vs 16.0%) statin users compared with nonusers.

The researchers concluded, “In a nationwide viral hepatitis cohort, lipophilic statins were associated with significantly reduced HCC incidence and mortality.” They added, “Further research is needed to determine whether lipophilic statin therapy is feasible for prevention of HCC.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Simon TG, Duberg A-S, Aleman S, et al. Lipophilic statins and risk for hepatocellular carcinoma and death in patients with chronic viral hepatitis: results from a nationwide Swedish population. Ann Intern Med 2019;171:318-327.

StephenW

親脂性他汀類藥物可減少肝細胞癌和慢性肝炎死亡
弗吉尼亞·夏德（Virginia A.
根據發表在《內科學年鑑》上的研究結果，親脂性他汀類藥物可能與顯著降低肝細胞癌（HCC）的發生率和死亡率有關。

全世界每年大約診斷出500,000例HCC病例，數據表明，在慢性肝病中，3-羥基-3-甲基戊二酰輔酶A還原酶抑製劑（他汀類藥物）可以改善臨床結果並降低HCC風險。但是，尚不清楚不同他汀類藥物對肝癌風險和生存的影響。因此，研究人員評估了瑞典全國性病毒性肝炎人群中親脂性或親水性他汀類藥物的使用與HCC發生率和死亡率之間的關係。


患者包括63,279名符合條件的成年人（15,104名乙肝病毒感染者和48,175名乙肝病毒感染者）中有16,668名成年人（開始使用他汀類藥物[6554親脂性和1780親水性]和8334名非使用者）的傾向得分匹配隊列。與非使用者相比，親脂性他汀類藥物使用者的10年HCC風險顯著降低（8.1％比3.3％），而不是親水性他汀類藥物使用者（8.0％對6.8％）。然而，親脂性他汀類藥物與HCC風險之間的負相關性似乎是劑量依賴性的，因為600或更多的親脂性他汀類藥物累積定義日劑量與非使用者相比，十年期HCC風險最低（2.5％比8.4％）。此外，與非使用者相比，親脂性他汀類藥物使用者的10年死亡率顯著降低（分別為7.3％和15.2％）和親水性（11.5％和16.0％）。

研究人員總結說：“在全國范圍內的病毒性肝炎隊列研究中，親脂性他汀類藥物顯著降低了HCC的發生率和死亡率。”他們補充說，“需要進一步的研究以確定親脂性他汀類藥物療法是否可預防HCC。”

披露：一些研究作者宣布與製藥行業有從屬關係。請參閱原始參考資料，以獲得作者披露的完整列表。

參考

Simon TG，Duberg A-S，Aleman S等。親脂性他汀類藥物與慢性病毒性肝炎患者發生肝細胞癌和死亡的風險：來自瑞典全國的結果。 Ann Intern Med 2019; 171：318-327。

lqman

TAF 是亲脂性吗？

StephenW

回复 lqman 的帖子

TAF不是他汀(statins)类药物.
Atorvastatin, lovastatin, and simvastatin are lipophilic, whereas pravastatin, rosuvastatin, and fluvastatin are more hydrophilic.
阿托伐他汀，洛伐他汀和辛伐他汀具有亲脂性，而普伐他汀，瑞舒伐他汀和氟伐他汀则具有更高的亲水性。