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Topics in Evidence-Based Pharmacy Practice
10/28/2011: Safety and Efficacy of Statin Therapy in Patients with Abnormal Liver Function Tests
Kavita Bhakta
Feik School of Pharmacy, University of the Incarnate Word, San Antonio, Texas
Marc Garza
Feik School of Pharmacy, University of the Incarnate Word, San Antonio, Texas
Amy P. Witte
Feik School of Pharmacy, University of the Incarnate Word, San Antonio, Texas
Excerpt:"Statins are used for both primary and secondary prevention of coronary artery disease. Multiple studies have shown liver-related adverse effects with raised concentrations of serum transaminases, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) with statin therapy.1 However, the use of statins in patients with raised transaminase enzymes (LFTs) due to non-alcoholic fatty liver disease (NAFLD) have shown improved liver histology and decreases in enzymes. The most common cause of elevated liver enzymes in the developed world is NAFLD.2 Its prevalence increases with age, body mass index, and high triglycerides. Furthermore, patients diagnosed with diabetes mellitus or hypertension are at increased risk of developing NAFLD. Patients who have NAFLD have a 69% increased chance of mortality due to cardiovascular disease.3 NAFLD treatment includes lifestyle modifications, such as dietary changes and exercise, or pharmacotherapy interventions. Statins have been used in the treatment of NAFLD. However, no study has been able to determine the risk-to-benefit ratio of statins in this population. ..."
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