Evidence map›Paper›PMID 31426090›Full record

ArticleAnnals of internal medicine2019

Lipophilic Statins and Risk for Hepatocellular Carcinoma and Death in Patients With Chronic Viral Hepatitis: Results From a Nationwide Swedish Population.

Tracey G Simon, Ann-Sofi Duberg, Soo Aleman, Hannes Hagstrom, Long H Nguyen, Hamed Khalili, Raymond T Chung, Jonas F Ludvigsson

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of internal medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 10 pooled it
5.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 10 syntheses or guidelines pooled it, 139 citations in OpenAlex.

  1. Pooled it
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  5. Guideline
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  7. A Meta-Analysis of Statin Use and Risk of Hepatocellular Carcinoma.Canadian journal of gastroenterology & hepatology · 2022
    Pooled it
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  9. [Meta-analysis of the effects of statins on the risk of chronic liver disease and hepatocellular carcinoma].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2021
    Pooled it
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  13. Article
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  15. Review
  16. Disease Modulating Agents in Cirrhosis.Clinics in liver disease · 2026
    Review
  17. Chemoprevention of hepatocellular carcinoma.Hepatology communications · 2025
    Review
  18. Review
  19. Article
  20. Article

18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 2 countries.

Tracey G SimonMassachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (T.G.S., L.H.N., R.T.C.).
Ann-Sofi DubergÖrebro University Hospital, Örebro, Sweden (A.D.).
Soo AlemanKarolinska University Hospital, Stockholm, Sweden (S.A.).
Hannes HagstromKarolinska University Hospital and Karolinska Institutet, Stockholm, Sweden (H.H.).
Long H NguyenMassachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (T.G.S., L.H.N., R.T.C.).
Hamed KhaliliMassachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, and Karolinska Institutet, Stockholm, Sweden (H.K.).
Raymond T ChungMassachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (T.G.S., L.H.N., R.T.C.).
Jonas F LudvigssonKarolinska Institutet and Karolinska University Hospital, Stockholm, Sweden, Örebro University Hospital, Örebro, Sweden, and Columbia University College of Physicians and Surgeons, New York, New York (J.F.L.).
Harvard University · USKarolinska University Hospital · SEMassachusetts General Hospital · USKarolinska Institutet · SEÖrebro University Hospital · SE

Funding

Patient-Oriented Research on Hepatitis in Special PopulationsK24DK078772 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI CHUNG, RAYMOND T · 2007 to 2016
$1.6M
Aspirin and Novel Lipid Mediators in Nonalcoholic Fatty Liver DiseaseK23DK122104 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI SIMON, TRACEY · 2019 to 2023
$1.1M
Oral Contraceptives in the Etiopathogenesis of Crohn's DiseaseK23DK099681 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI KHALILI, HAMED · 2013 to 2017
$946k
NIDDK NIH HHS K23 DK099681NIDDK NIH HHS K23 DK122104NIDDK NIH HHS K24 DK078772
6 · The paper itself

Abstract

Background: Whether statin type influences hepatocellular carcinoma (HCC) incidence or mortality in chronic hepatitis B or C virus infection is unknown. Objective: To assess the relationship between lipophilic or hydrophilic statin use and HCC incidence and mortality in a nationwide population with viral hepatitis. Design: Prospective propensity score (PS)-matched cohort. Setting: Swedish registers, 2005 to 2013. Participants: A PS-matched cohort of 16 668 adults (8334 who initiated statin use [6554 lipophilic and 1780 hydrophilic] and 8334 nonusers) among 63 279 eligible adults. Measurements: Time to incident HCC, ascertained from validated registers. Statin use was defined from filled prescriptions as 30 or more cumulative defined daily doses (cDDDs). Results: Compared with matched nonusers, 10-year HCC risk was significantly lower among lipophilic statin users (8.1% vs. 3.3%; absolute risk difference [RD], -4.8 percentage points [95% CI, -6.2 to -3.3 percentage points]; adjusted subdistribution hazard ratio [aHR], 0.56 [CI, 0.41 to 0.79]) but not hydrophilic statin users (8.0% vs. 6.8%; RD, -1.2 percentage points [CI, -2.6 to 0.4 percentage points]; aHR, 0.95 [CI, 0.86 to 1.08]). The inverse association between lipophilic statins and HCC risk seemed to be dose-dependent. Compared with nonusers, 10-year HCC risk was lowest with 600 or more lipophilic statin cDDDs (8.4% vs. 2.5%; RD, -5.9 percentage points [CI, -7.6 to -4.2 percentage points]; aHR, 0.41 [CI, 0.32 to 0.61]), and 10-year mortality was significantly lower among both lipophilic (15.2% vs. 7.3%; RD, -7.9 percentage points [CI, -9.6 to -6.2 percentage points]) and hydrophilic (16.0% vs. 11.5%; RD, -4.5 percentage points [CI, -6.0 to -3.0 percentage points]) statin users. Limitation: Lack of lipid, fibrosis, or HCC surveillance data. Conclusion: In a nationwide viral hepatitis cohort, lipophilic statins were associated with significantly reduced HCC incidence and mortality. An association between hydrophilic statins and reduced risk for HCC was not found. Further research is needed to determine whether lipophilic statin therapy is feasible for prevention of HCC. Primary Funding Source: None.

Indexed as

Carcinoma, HepatocellularCause of DeathDose-Response Relationship, DrugDuration of TherapyHepatitis B, ChronicHepatitis C, ChronicHumansHydrophobic and Hydrophilic InteractionsHydroxymethylglutaryl-CoA Reductase InhibitorsIncidenceLipid MetabolismLiver NeoplasmsPropensity ScoreRegistriesRisk FactorsSwedenHydroxymethylglutaryl-CoA Reductase Inhibitors

Identifiers

PMID31426090
PMCPMC8246628
OpenAlexW2969516088

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.