Statins increase the risk of liver damage

This study was published in the Medical Journal of Basrah University Vol: 25, No: 1 2007

Study title and authors:
Comparative Effects of Lovastatin and Simvastatin on Liver Function tests in Hyperlipidaemic Patients
Zena Sattam, Hamad Al-Jubori, Isam Hamo Mahmood
This study can be accessed at: http://www.iasj.net/iasj?func=fulltext&aId=48121

Drug-induced liver damage has become an important public health problem, contributing to more than 50% of acute liver failure cases, and there have been observations of a large number of liver failure cases on statin therapy. 

In liver function tests, liver damage is confirmed with increased levels of bilirubin and the liver enzymes; Alanine transaminase, aspartate aminotransferase and alkaline phosphatase.

This study measured the effects of statins on liver function tests. The study included: 

(i) 53 patients, aged 35-60 years, took simvastatin therapy. The simvastatin dose ranged from 10 to 20mg a day. Duration of treatment ranged from one month to four years. (Simvastatin group).
(ii) 42 patients, aged 38-60, took lovastatin therapy. The lovastatin dose ranged from 10 to 20mg a day. Duration of treatment ranged from one month to three years. (Lovastatin group).
(iii) A control group of 50 subjects, aged 35-58 who did not take statins. (No-statin group).

The study found:
(a) The alanine transaminase levels of the lovastatin group were 113% higher than the no-statin group.
(b) The aspartate aminotransferase levels of the lovastatin group were 90% higher than the no-statin group.
(c) The alkaline phosphatase levels of the lovastatin group were 11% higher than the no-statin group.(d) The bilirubin levels of the lovastatin group were 40% higher than the no-statin group.
(e) The alanine transaminase levels of the high dose (20 mg a day) lovastatin group were 181% higher than the no-statin group.
(f) The aspartate aminotransferase levels of the high dose (20 mg a day) lovastatin group were 151% higher than the no-statin group.
(g) The alkaline phosphatase levels of the high dose (20 mg a day) lovastatin group were 20% higher than the no-statin group.
(h) The bilirubin levels of the high dose (20 mg a day) lovastatin group were 72% higher than the no-statin group.
(i) The alanine transaminase levels of the long term usage (over 12 months) lovastatin group were 333% higher than the no-statin group.
(j) The aspartate aminotransferase levels of the long term usage (over 12 months) lovastatin group were 321% higher than the no-statin group.
(k) The alkaline phosphatase levels of the long term usage (over 12 months) lovastatin group were 24% higher than the no-statin group.
(l) The bilirubin levels of the long term usage (over 12 months) lovastatin group were 145% higher than the no-statin group.
(m) The alanine transaminase levels of the simvastatin group were 103% higher than the no-statin group.
(n) The aspartate aminotransferase levels of the simvastatin group were 60% higher than the no-statin group.
(o) The alkaline phosphatase levels of the simvastatin group were 6% higher than the no-statin group.(p) The bilirubin levels of the simvastatin group were 45% higher than the no-statin group.
(q) The alanine transaminase levels of the high dose (20 mg a day) simvastatin group were 150% higher than the no-statin group.
(r) The aspartate aminotransferase levels of the high dose (20 mg a day) simvastatin group were 102% higher than the no-statin group.
(s) The alkaline phosphatase levels of the high dose (20 mg a day) simvastatin group were 3% higher than the no-statin group.
(t) The bilirubin levels of the high dose (20 mg a day) simvastatin group were 55% higher than the no-statin group.
(u) The alanine transaminase levels of the long term usage (over 12 months) simvastatin group were 255% higher than the no-statin group.
(v) The aspartate aminotransferase levels of the long term usage (over 12 months) simvastatin group were 240% higher than the no-statin group.
(w) The alkaline phosphatase levels of the long term usage (over 12 months) simvastatin group were 3% higher than the no-statin group.
(x) The bilirubin levels of the long term usage (over 12 months) simvastatin group were 83% higher than the no-statin group.

The results from this study revealed significant increases of alanine transaminase, aspartate aminotransferase and bilirubin levels in the lovastatin group compared with the control group and significant increases of alanine transaminase and bilirubin in the simvastatin group when compared with the control group.

The study also revealed that the higher the dose of the statin or the longer the dose of the statin generally correlated with increased levels of the liver enzymes.

Statin users have a 26% increased risk of liver function test abnormalities

This study was published in Pharmacotherapy 2004 May;24(5):584-91

 

Study title and authors:

Statins and liver toxicity: a meta-analysis.

de Denus S, Spinler SA, Miller K, Peterson AM.

Philadelphia College of Pharmacy, University of the Sciences in Philadelphia, PA 19103-4495, USA.

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/15162892

Liver function tests measure various chemicals in the blood made by the liver. An abnormal result indicates the presence of liver disease.

The objective of the study was to assess the risk of liver function test abnormalities with the use of statins. The study was a meta-analysis of 13 randomized, placebo-controlled trials of statins including 49,275 patients.

The study found that statin users had a 26% increased risk of liver function test abnormalities compared to non users.

After six months of taking statins, over 20% of people develop muscle pain

This study was published in Arquivos Brasileiros de Cardiologia 2014 Jul;103(1):33-40

 

Study title and authors:

Evaluation of sexual dimorphism in the efficacy and safety of simvastatin/atorvastatin therapy in a southern brazilian cohort.

Smiderle L, Lima LO, Hutz MH, Sand CR, Van der Sand LC, Ferreira ME, Pires RC, Almeida S, Fiegenbaum M.

Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25120083

This study evaluated the effects of simvastatin/atorvastatin on men and women. The six month study included 495 patients, aged 25-82 years, (331 women and 164 men), who received simvastatin/atorvastatin.

When high levels of creatine phosphokinase are detected in the blood, it is considered to be an abnormal result. High levels of the enzyme may occur due to the following conditions:

• heart attack
• pericarditis after a heart attack
• polymyositis or dermamyositis
• heart muscle inflammation
• myopathy (a disease of the muscles)
• rhabdomyolysis (a breakdown of muscle tissues)
• muscular dystrophies
• convulsions
• stroke
• brain injury
• delirium tremens
• hypothyroidism (a decrease in the activity of the thyroid gland) or hyperthyroidism (an increase in activity of the thyroid gland)
• death of lung tissue

After six months the study found:
(a) 20.3% of the patients developed muscle pain.
(b) 11.1% of the patients had increased creatine phosphokinase levels and/or abnormal liver function.