| Abstract: | INTRODUCTION: Practicing physicians often hesitate to use statins and/or other lipid lowering therapies in NAFLD due to concern for hepatotoxicity. AIM: To examine safety of lipid lowering therapies in NAFLD patients. METHODS: Data from randomized control trials (RCT) among NAFLD patients were pooled to examine effect of lipid lowering therapies on liver chemistry, lipid profile, and liver histology. Results are reported as mean difference of the change (pretreatment-posttreatment) between treatment and control group. RESULTS: A total of 21 placebo controlled RCT on 1900 patients (304 receiving statins, 520 other lipid lowering therapies, and 61 combination) were treated for 26 weeks [Interquartile range (IQR): 17.5-52 weeks]. Pooled data showed improved lipid profile without any worsening of ALT, AST, total bilirubin, or alkaline phosphatase at the end of treatment period. NAFLD activity score improved with other lipid lowering agents but not with statins. There was no change in individual components of NAFLD activity score or fibrosis stage. CONCLUSION: This meta-analysis of randomized controlled trials examining statins and/or other lipid lowering therapies in NAFLD patients showed no evidence for worsening of liver chemistry. Studies with longer use of lipid lowering therapies are suggested to examine benefit on liver histology among patients with NAFLD. |
