Network Meta-analysis Of Effects Of Different Statins On Liver Function

Objective:As one of the most commonly used drugs,statins’ adverse reactions,especially hepatotoxicity,have become a growing concern.However,the assessment of the effects of different statins on liver function still varies at present.The aim of this study was to systematically review the effects of different statins on liver function.Methods:We searched electronic databases,including PubMed,Cochrane Library,Embase and MEDLINE to collect randomized controlled trials(RCTs)about abnormal liver function associated with statins as the intervention from inception to September 10 th 2020.Literature review,data extraction,and risk of bias evaluation were performed by two researchers.Stata 14 was used for network meta-analysis.Results:All in all,46 RCTs involving 54499 patients were included.The results were as follows:Atorvastatin had more abnormal liver function than rosuvastatin [RR = 1.70,95% CI(1.04,2.78)]、pravastatin [RR = 2.19,95% CI(1.06,4.52)],atorvastatin [RR = 2.40,95% CI(1.54,3.73)]、rosuvastatin [RR = 1.41,95% CI(1.11,1.79)] were more than placebo;statins metabolized by CYP450[RR=1.87,95%CI(1.34,2.63)]were more than placebo;liposoluble statins [RR = 1.81,95% CI(1.30,2.51)] were more than placebo;atorvastatin40-80 mg is more than pitavastatin 1-4mg [RR = 4.15,95% CI(1.07,16.08)]、pravastatin40-80 mg [RR = 2.87,95% CI(1.32,6.24)]、simvastatin 20-80 mg [RR = 3.50,95% CI(1.45,8.49)]、rosuvatorstatin 20-80 mg [RR = 2.39,95% CI(1.30,4.39)]、rosuvatorstatin 5-10mg[RR = 4.49,95% CI(1.29,15.60)],atorvastatin 40-80 mg [RR = 3.44,95% CI(1.95,6.04)]、rosuvastatin 20-80 mg [RR = 1.44,95% CI(1.13,1.82)] were more than placebo,the difference was statistically significant.Conclusion:Lipid soluble statins,statins metabolized by CYP450 enzymes and high-dose statins have higher probability of liver dysfunction.There are many literatures included in this study and the overall quality is acceptable,which has certain guiding significance for clinical medication.