New Evidence Supports Cholesterol Absorption Inhibitors in Liver Cancer Prevention

Use of non-statin cholesterol-lowering agents was linked to a lower risk of liver cancer in a study conducted by authors from the National Institutes of Health. The results, published in Cancer, demonstrated that cholesterol absorption inhibitors decreased the risk of developing liver cancer by 31%. These significant findings may advance liver cancer prevention efforts, as well as support the potential incorporation of cholesterol absorption inhibitors into care plans, allowing clinicians to develop personalized preventive strategies for at-risk patients.¹

The findings have positive implications for at-risk patients who may experience adverse effects, such as muscle aches or joint pain, when taking statin agents. Image Credit: © svetazi - stock.adobe.com

Liver cancer is the sixth most common malignancy and the leading cause of cancer deaths worldwide, accounting for more than 700,000 deaths each year. Significant risk factors for liver cancer heavy alcohol use, tobacco use, type 2 diabetes (T2D) and obesity, as well as are chronic hepatitis B virus, chronic infection with hepatitis C virus. Considering the 5-year survival rate of 37% for localized disease, prevention is key for encouraging optimal health outcomes.^2,3

In recent years, statins have been widely studied and research indicates statins may lower the risk of liver cancer; however, the association between non-statin cholesterol lowering inhibitors and reduced risk has not been well examined. To better understand the potential relationship and benefits of non-statin medications and liver cancer risk, the researchers examined 5 classes of agents: cholesterol absorption inhibitors, bile acid sequestrants, fibrates, omega-3 fatty acids, and niacin.⁴

The nested case-control study utilized the Clinical Practice Research Datalink to identify and compare 3719 individuals with liver cancer and 14,876 matched controls who did not have cancer. The researchers also included matches on T2D and chronic liver disease. They found that cholesterol absorption inhibitors were associated with reduced liver cancer risk in the overall analysis (odds ratio, 0.69; 95% confidence interval [CI], 0.50–0.96), as well as analyses based on T2D and chronic liver disease.⁴

Of the other non-statin agents included in the study, there were no observed associations with liver cancer risk for fibrates, omega-3 fatty acids, or niacin; however, bile acid sequestrant was linked to an increased risk (odds ratio, 5.31; 95% CI, 3.534–7.97). The study also confirmed that statins were associated with 35% decreased risk of liver cancer.⁴

The findings have positive implications for at-risk patients who may experience adverse effects, such as muscle aches or joint pain, when taking statin agents. The capabilities of non-statin cholesterol-lowering treatments could expand access to efficacious preventative methods to reduce the risk of liver cancer.

“As few studies have examined the effects of non-statin cholesterol-lowering drugs on liver cancer risk, the results of our study require replication in other populations,” said Katherine A. McGlynn, PhD, MPH, senior investigator at National Cancer Institute, in a press release. “If our findings are confirmed in other studies, however, our results may inform liver cancer prevention research,” said Dr. McGlynn.”¹

References

1. Do non-statin cholesterol-lowering drugs affect liver cancer risk. Wiley. July 29, 2024. Accessed August 8, 2024. https://newsroom.wiley.com/press-releases/press-release-details/2024/Do-non-statin-cholesterol-lowering-drugs-affect-liver-cancer-risk/default.aspx

2. Key statistics about liver cancer. American Cancer Society. January 17, 2024. Accessed August 8, 2024. https://www.cancer.org/cancer/types/liver-cancer/about/what-is-key-statistics.html

3. Liver cancer survival rates. American Cancer Society. January 17, 2024. Accessed August 8, 2024. https://www.cancer.org/cancer/types/liver-cancer/detection-diagnosis-staging/survival-rates.html

4. Zamani S, Graubard B, Hyer M, et al. Use of cholesterol-lowering medications in relation to risk of primary liver cancer in the clinical practice research datalink. Cancer. July 29, 2024. doi:10.1002/cncr.35436