A Review of Liver Damage Caused by Statins

Alireza  Bagheri; Mohammad  Mashhadi Akbar Boojar; Mahdi Mashhadi  Akbar Boojar

doi:10.18502/aptj.v5i2.19453

Alireza Bagheri Student research committee, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Mohammad Mashhadi Akbar Boojar Student research committee, Mazandaran University of Medical Sciences, Sari, Iran.
Mahdi Mashhadi Akbar Boojar Department of Pharmacology and Toxicology, Faculty of Pharmacy, Baqiyatallah University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aptj.v5i2.19453

Keywords: Drug-induced liver injury, Statin, Cholestatic liver injury, Hepatocellular liver injury, Cholestasis

Abstract

Introduction: Statins, or HMG-CoA reductase inhibitors, are among the most widely used drugs for controlling hyperlipidemia and cardiovascular diseases. They are generally considered low-risk, but sometimes, it has been reported that they can damage liver tissue with cholestatic damage or liver parenchyma. The current review addresses statins-induced liver injury, focusing on clinical presentation, diagnostic approach, and disease management.

Methods: For English-language studies, a comprehensive search using keywords selected according to the MeSH model, including "drug-induced liver injury, statin, cholestatic liver injury, cellular liver injury, and cholestasis," was conducted in PubMed, Scopus, and Google Scholar databases.

Results: Studies show that mild liver dysfunction, characterized by an increase in aminotransferases, may occur in about three percent of patients, while severe liver damage is rare and usually reversible with discontinuation of the causative statin. In suspected liver damage caused by statins, a comprehensive evaluation can be performed by taking a detailed medical history and performing laboratory investigations, including imaging studies and valid assays such as the Roussel Uclaf Causality Assessment Method (RUCAM).

Conclusion: Statins used to lower blood lipids can lead to liver damage, mainly cholestatic or hepatocyte damage. It is important to pay attention to the health of the liver while taking this drug class, and the final diagnosis of the occurrence of this complication is based on a comprehensive evaluation, monitoring of liver function, and awareness of drug interactions. More research is needed to determine strategies to reduce risk.