Statins increase the risk of liver damage

This study was published in the Medical Journal of Basrah University Vol: 25, No: 1 2007

Study title and authors:
Comparative Effects of Lovastatin and Simvastatin on Liver Function tests in Hyperlipidaemic Patients
Zena Sattam, Hamad Al-Jubori, Isam Hamo Mahmood
This study can be accessed at: http://www.iasj.net/iasj?func=fulltext&aId=48121

Drug-induced liver damage has become an important public health problem, contributing to more than 50% of acute liver failure cases, and there have been observations of a large number of liver failure cases on statin therapy. 

In liver function tests, liver damage is confirmed with increased levels of bilirubin and the liver enzymes; Alanine transaminase, aspartate aminotransferase and alkaline phosphatase.

This study measured the effects of statins on liver function tests. The study included: 

(i) 53 patients, aged 35-60 years, took simvastatin therapy. The simvastatin dose ranged from 10 to 20mg a day. Duration of treatment ranged from one month to four years. (Simvastatin group).
(ii) 42 patients, aged 38-60, took lovastatin therapy. The lovastatin dose ranged from 10 to 20mg a day. Duration of treatment ranged from one month to three years. (Lovastatin group).
(iii) A control group of 50 subjects, aged 35-58 who did not take statins. (No-statin group).

The study found:
(a) The alanine transaminase levels of the lovastatin group were 113% higher than the no-statin group.
(b) The aspartate aminotransferase levels of the lovastatin group were 90% higher than the no-statin group.
(c) The alkaline phosphatase levels of the lovastatin group were 11% higher than the no-statin group.(d) The bilirubin levels of the lovastatin group were 40% higher than the no-statin group.
(e) The alanine transaminase levels of the high dose (20 mg a day) lovastatin group were 181% higher than the no-statin group.
(f) The aspartate aminotransferase levels of the high dose (20 mg a day) lovastatin group were 151% higher than the no-statin group.
(g) The alkaline phosphatase levels of the high dose (20 mg a day) lovastatin group were 20% higher than the no-statin group.
(h) The bilirubin levels of the high dose (20 mg a day) lovastatin group were 72% higher than the no-statin group.
(i) The alanine transaminase levels of the long term usage (over 12 months) lovastatin group were 333% higher than the no-statin group.
(j) The aspartate aminotransferase levels of the long term usage (over 12 months) lovastatin group were 321% higher than the no-statin group.
(k) The alkaline phosphatase levels of the long term usage (over 12 months) lovastatin group were 24% higher than the no-statin group.
(l) The bilirubin levels of the long term usage (over 12 months) lovastatin group were 145% higher than the no-statin group.
(m) The alanine transaminase levels of the simvastatin group were 103% higher than the no-statin group.
(n) The aspartate aminotransferase levels of the simvastatin group were 60% higher than the no-statin group.
(o) The alkaline phosphatase levels of the simvastatin group were 6% higher than the no-statin group.(p) The bilirubin levels of the simvastatin group were 45% higher than the no-statin group.
(q) The alanine transaminase levels of the high dose (20 mg a day) simvastatin group were 150% higher than the no-statin group.
(r) The aspartate aminotransferase levels of the high dose (20 mg a day) simvastatin group were 102% higher than the no-statin group.
(s) The alkaline phosphatase levels of the high dose (20 mg a day) simvastatin group were 3% higher than the no-statin group.
(t) The bilirubin levels of the high dose (20 mg a day) simvastatin group were 55% higher than the no-statin group.
(u) The alanine transaminase levels of the long term usage (over 12 months) simvastatin group were 255% higher than the no-statin group.
(v) The aspartate aminotransferase levels of the long term usage (over 12 months) simvastatin group were 240% higher than the no-statin group.
(w) The alkaline phosphatase levels of the long term usage (over 12 months) simvastatin group were 3% higher than the no-statin group.
(x) The bilirubin levels of the long term usage (over 12 months) simvastatin group were 83% higher than the no-statin group.

The results from this study revealed significant increases of alanine transaminase, aspartate aminotransferase and bilirubin levels in the lovastatin group compared with the control group and significant increases of alanine transaminase and bilirubin in the simvastatin group when compared with the control group.

The study also revealed that the higher the dose of the statin or the longer the dose of the statin generally correlated with increased levels of the liver enzymes.

Atorvastatin linked to abnormally high calcium levels

This paper was published in the Archives of the Turkish Society of Cardiology 2014 Oct;42(7):662-6

 

Study title and authors:

Can atorvastatin calcium cause asymptomatic hypercalcemia?

Ipekçi SH, Baldane S, Sözen M, Kebapçılar L

Department of Internal Medicine, Division of Endocrinology and Metabolism, Selcuk University Faculty of Medicine, Konya, Turkey.

 

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25490303

Hypercalcemia is a condition in which the calcium level in your blood is above normal. Too much calcium in your blood can weaken your bones, create kidney stones, and interfere with the way your heart and brain works.

This paper reports the case of a woman who developed hypercalcemia after starting atorvastatin.

(i) A 52-year-old female was referred to hospital for hypercalcemia.
(ii) She had been taking atorvastatin for 1.5 years.
(iii) Atorvastatin induced hypercalcemia was suspected.
(iii) Exhaustive tests were conducted that ruled out all other causes of hypercalcemia.
(iv) She stopped taking atorvastatin and her calcium levels returned to normal.
(v) She restarted atorvastatin and again her hypercalcemia returned.
(vi) She again stopped taking atorvastatin and her calcium levels returned to normal.

Long-term exposure to statins may be associated with drug-induced lupus erythematosus and other autoimmune disorders

This study was published in the Journal of the European Academy of Dermatology and Venereology 2007 Jan;21(1):17-24

 

Study title and author:

Lupus erythematosus and other autoimmune diseases related to statin therapy: a systematic review.

Noël B.

Department of Dermatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. bernard.noel@chuv.hospvd.ch

 

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/17207162

This paper reviewed the scientific literature concerning statin-induced autoimmune diseases including lupus erythematosus.

The review found:
(a) Statins were associated with various autoimmune diseases such as systemic lupus erythematosus, subacute cutaneous lupus erythematosus, dermatomyositis, polymyositis and lichen planus pemphigoides.
(b) Autoimmune hepatitis was observed in some patients with systemic lupus erythematosus.
(c) The average time of exposure before disease onset was 12 months, with a range from one month to six years.
(d) Aggressive immunosuppressive therapy was required in the majority of cases to aid clinical recovery.
(e) Some patients died despite the immunosuppressive therapy.

Noel concludes: "Long-term exposure to statins may be associated with drug-induced lupus erythematosus and other autoimmune disorders. Fatal cases have been reported despite early drug discontinuation and aggressive systemic immunosuppressive therapy".