Safety and efficacy of dyslipidemia treatment in NAFLD patients: a meta-analysis of randomized controlled trials
Introduction and Objectives: Practicing physicians often hesitate to use statins and/or other lipid-lowering therapies in NAFLD due to concern for hepatotoxicity. The aim of this study is to examine the safety of lipid lowering therapies in NAFLD patients. Materials and Methods: Data from randomized...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-11-01
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| Series: | Annals of Hepatology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268122000801 |
| _version_ | 1811246929469767680 |
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| author | Mohamed Abdallah Landon Brown John Provenza Raseen Tariq Smitha Gowda Ashwani K. Singal |
| author_facet | Mohamed Abdallah Landon Brown John Provenza Raseen Tariq Smitha Gowda Ashwani K. Singal |
| author_sort | Mohamed Abdallah |
| collection | DOAJ |
| description | Introduction and Objectives: Practicing physicians often hesitate to use statins and/or other lipid-lowering therapies in NAFLD due to concern for hepatotoxicity. The aim of this study is to examine the safety of lipid lowering therapies in NAFLD patients. Materials and Methods: Data from randomized control trials (RCT) among NAFLD patients were pooled to examine the effect of lipid-lowering therapies on liver chemistry, lipid profile, and liver histology. Results are reported as the mean difference of the change (pretreatment-posttreatment) between the treatment and control group. Results: A total of 21 placebo-controlled RCT on 1900 patients (304 receiving statins, 520 other lipid-lowering therapies, and 61 combinations) were treated for 26 weeks [Interquartile range (IQR): 17.5-52 weeks]. Pooled data showed an improved lipid profile without any worsening of ALT, AST, total bilirubin, or alkaline phosphatase at the end of the treatment period. NAFLD activity score improved with other lipid-lowering agents but not with statins. There was no change in individual components of NAFLD activity score or fibrosis stage. Conclusion: This meta-analysis of randomized controlled trials examining statins and/or other lipid-lowering therapies in NAFLD patients showed no evidence of worsening liver chemistry. Studies with longer use of lipid-lowering therapies are suggested to examine the benefit of liver histology among patients with NAFLD. |
| first_indexed | 2024-04-12T15:01:52Z |
| format | Article |
| id | doaj.art-15e6ae18840c433daf257ae89d08462e |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-04-12T15:01:52Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-15e6ae18840c433daf257ae89d08462e2022-12-22T03:28:04ZengElsevierAnnals of Hepatology1665-26812022-11-01276100738Safety and efficacy of dyslipidemia treatment in NAFLD patients: a meta-analysis of randomized controlled trialsMohamed Abdallah0Landon Brown1John Provenza2Raseen Tariq3Smitha Gowda4Ashwani K. Singal5Department of Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, SD, United StatesDepartment of Medicine, University of Alabama at Birmingham, Birmingham, AL, United StatesDepartment of Medicine, University of Alabama at Birmingham, Birmingham, AL, United StatesDepartment of Medicine, University of Rochester, NY, United StatesDepartment of Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, SD, United StatesDepartment of Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, SD, United States; Division of Transplant Hepatology, Avera Transplant Institute, Sioux Falls, SD, United States; Corresponding author.Introduction and Objectives: Practicing physicians often hesitate to use statins and/or other lipid-lowering therapies in NAFLD due to concern for hepatotoxicity. The aim of this study is to examine the safety of lipid lowering therapies in NAFLD patients. Materials and Methods: Data from randomized control trials (RCT) among NAFLD patients were pooled to examine the effect of lipid-lowering therapies on liver chemistry, lipid profile, and liver histology. Results are reported as the mean difference of the change (pretreatment-posttreatment) between the treatment and control group. Results: A total of 21 placebo-controlled RCT on 1900 patients (304 receiving statins, 520 other lipid-lowering therapies, and 61 combinations) were treated for 26 weeks [Interquartile range (IQR): 17.5-52 weeks]. Pooled data showed an improved lipid profile without any worsening of ALT, AST, total bilirubin, or alkaline phosphatase at the end of the treatment period. NAFLD activity score improved with other lipid-lowering agents but not with statins. There was no change in individual components of NAFLD activity score or fibrosis stage. Conclusion: This meta-analysis of randomized controlled trials examining statins and/or other lipid-lowering therapies in NAFLD patients showed no evidence of worsening liver chemistry. Studies with longer use of lipid-lowering therapies are suggested to examine the benefit of liver histology among patients with NAFLD.http://www.sciencedirect.com/science/article/pii/S1665268122000801 |
| spellingShingle | Mohamed Abdallah Landon Brown John Provenza Raseen Tariq Smitha Gowda Ashwani K. Singal Safety and efficacy of dyslipidemia treatment in NAFLD patients: a meta-analysis of randomized controlled trials Annals of Hepatology |
| title | Safety and efficacy of dyslipidemia treatment in NAFLD patients: a meta-analysis of randomized controlled trials |
| title_full | Safety and efficacy of dyslipidemia treatment in NAFLD patients: a meta-analysis of randomized controlled trials |
| title_fullStr | Safety and efficacy of dyslipidemia treatment in NAFLD patients: a meta-analysis of randomized controlled trials |
| title_full_unstemmed | Safety and efficacy of dyslipidemia treatment in NAFLD patients: a meta-analysis of randomized controlled trials |
| title_short | Safety and efficacy of dyslipidemia treatment in NAFLD patients: a meta-analysis of randomized controlled trials |
| title_sort | safety and efficacy of dyslipidemia treatment in nafld patients a meta analysis of randomized controlled trials |
| url | http://www.sciencedirect.com/science/article/pii/S1665268122000801 |
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