Clinical

Elevated liver enzymes no bar to statin use in hyperlipidemia

Last Updated: 2004-05-10 12:40:16 -0400 (Reuters Health)

NEW YORK (Reuters Health) - The use of statins in the presence of elevated liver enzymes does not raise the risk of hepatotoxicity, according to a report published in the May issue of Gastroenterology.

The researchers note that although the National Cholesterol Education Program recommends that statins not be employed in patients with active liver disease, few studies have looked at the risk of statin hepatotoxicity in patients with elevated baseline levels of liver enzymes.

Dr. Naga Chalasani, from the Indiana University School of Medicine in Indianapolis, and colleagues compared 6-month liver biochemical changes in three groups of patients.

These consisted of 342 hyperlipidemic patients with elevated baseline enzyme levels, who were prescribed a statin, 1437 hyperlipidemic patients with normal baseline liver enzymes who were prescribed a statin and 2245 patients with elevated enzymes who were not treated with a statin.

During follow-up, in statin-treated patients in the elevated enzyme group, the rates of mild- to-moderate and severe biochemical elevations were 4.7% and 0.6%, respectively. The corresponding rates in patients with normal enzyme levels were 1.9% and 0.2%. The difference in severe elevations was not significant.

Moreover, both rate levels were comparable in patients with elevated enzymes whether or not they were in the treatment group, suggesting that the observed elevations may not have been due to statin therapy. The statin discontinuation rate among patients in both of these groups was similar-about 11%.

These results, the team concludes, "suggest that individuals with elevated liver enzymes do not have increased susceptibility to hepatotoxicity from statins."

Gastroenterology 2004;126:1287-1292.