Primary biliary cirrhosis (PBC) and statin treatment

Primary biliary cirrhosis (PBC) is frequently associated with hypercholesterolemia and with an increased cardiovascular morbidity and mortality.

Statins are safe in PBC patients(1)

A trial investigating treatment with low-dose atorvastatin for 12 months was found to be safe in early-stage PBC

• the statin treatment was shown to effectively reduce total cholesterol, LDL-C, LDL triglycerides, and improve vascular function, without affecting cholestasis progression. Therefore, statin therapy should be considered in PBC patients with additional risk factors for cardiovascular disease
• no statistical differences in liver enzymes were observed except a transient increase of alkaline phosphatase

Statins in modulation of disease:

• in a small study (3) simvastatin significantly (P<0.05) reduced serum levels of total cholesterol, LDL cholesterol, alkaline phosphatase, glutamyltransferase, and immunoglobulin M
  • the study authors stated that '..The lipid lowering potency of the HMG-CoA reductase inhibitor simvastatin was confirmed in hypercholesterolemic patients with PBC. The drug might also prove useful as modulator of cholestasis and of immune response in this disease...'

Reference:

• 1) Abu Rajab M, Kaplan MM. Statins in primary biliary cirrhosis: are they safe? Dig Dis Sci. 2010 Jul;55(7):2086-8.
• 2) Stojakovic T et al. Low-dose atorvastatin improves dyslipidemia and vascular function in patients with primary biliary cirrhosis after one year of treatment. Atherosclerosis. 2010 Mar;209(1):178-83.
• 3) Ritzel U et al.Simvastatin in primary biliary cirrhosis: effects on serum lipids and distinct disease markers. J Hepatol. 2002 Apr;36(4):454-8