Statins After MASLD-Cirrhosis Decompensation: Digestive Diseases and Sciences

Introduction:

Statins have been associated with potential hepatic benefits in compensated cirrhosis, but whether they improve outcomes after MASLD cirrhosis has already decompensated remains uncertain. This study examined outcomes after continuing versus discontinuing statins following hospitalisation for hepatic decompensation.

Why was this study needed?

Statins are frequently prescribed for cardiovascular risk in MASLD.

Observational studies have suggested possible benefits in portal hypertension and cirrhosis progression.

Evidence after hepatic decompensation remains limited.

Key Findings:

The TriNetX analysis propensity-matched 1,108 prior statin users with decompensated MASLD cirrhosis.

One-year recurrent decompensation was virtually identical: 62.1% with statin continuation vs 61.6% without.

Mortality was also similar: 19.7% vs 19.5%.

Lower transplantation but higher hospitalization with statins were considered exploratory findings.

These data do not support statins specifically for preventing recurrent hepatic decompensation.

Importantly, the findings do not justify stopping statins when indicated for cardiovascular risk reduction.

Retrospective design and residual confounding limit causal interpretation.

Bottom Line:

Continuing statins after MASLD-cirrhosis decompensation did not reduce recurrent decompensation or mortality. Statin decisions should remain driven primarily by cardiovascular indication rather than an expected liver-specific benefit.