Evidence map›Paper›PMID 36540900›Full record

ArticleClinical epidemiology2022

Statin Use and Severe Acute Liver Injury Among Patients with Elevated Alanine Aminotransferase.

Santosh K Verma, Joanna Huang, Howard G Hutchinson, Irisdaly Estevez, Kammy Kuang, Shannon L Reynolds, Sebastian Schneeweiss

Open access · goldAbstract read
In one paragraph

Article in Clinical epidemiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 22% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
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

7 authors at 4 institutions in 1 country.

Santosh K VermaScience, Aetion, Inc, New York, NY, USA.ORCID 0000-0001-9285-0325
Joanna HuangPayer Evidence, AstraZeneca, Wilmington, DE, USA.
Howard G HutchinsonGlobal Medicines Development, AstraZeneca, Wilmington, DE, USA.
Irisdaly EstevezScience, Aetion, Inc, New York, NY, USA.ORCID 0000-0002-4021-0438
Kammy KuangScience, Aetion, Inc, New York, NY, USA.
Shannon L ReynoldsScience, Aetion, Inc, New York, NY, USA.ORCID 0000-0003-1488-6044
Sebastian SchneeweissScience, Aetion, Inc, New York, NY, USA.ORCID 0000-0003-2575-467X
Aetion (United States) · USAstraZeneca (United States) · USBrigham and Women's Hospital · USUniversity of Massachusetts Chan Medical School · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: While serious liver injury among statin users is extremely rare, baseline liver enzyme testing is still recommended prior to initiating therapy. The benefit of such screening should be reevaluated based on empirical evidence. This study compared the risk of severe acute liver injury (SALI) between statin initiators with an elevated ALT (>35U/L) matched to statin initiators with a normal ALT level (≤35U/L). Statin initiators with an elevated ALT were additionally compared against matched non-users. Methods: The study created cohorts from Optum and MarketScan claims data. Exposed and comparison cohorts were propensity score (PS) matched in each dataset and findings were pooled using meta-analysis. Proportional hazards regression was used to estimate hazard ratios (HRs), and a prespecified non-inferiority margin for SALI was set at a HR of 1.8. Results: 232,889 patients with elevated ALT were PS-matched to 232,889 with normal ALT level. The overall incidence rate of SALI was about 19/100,000 person-years among statin initiators. Statin initiators with elevated ALT had no meaningfully increased risk of SALI compared to those with normal ALT (HR=1.15; 95% CI 0.75 to 1.75). Comparing statin initiators with non-initiators with elevated ALT values equally yielded no increased risk (HR=0.76; 95% CI 0.52 to 1.11). Conclusion: In this large population-based study, SALI in statin users was rare. Importantly, the results showed no evidence that baseline ALT status is a reliable indicator for an increased risk of severe liver injury among statin initiators.

Indexed as

alanine aminotransferaseliver failureliver injurystatins

Identifiers

PMID36540900
PMCPMC9759991
OpenAlexW4311327008

What OpenQuestion holds

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LicenceCC BY-NC
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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.