Statins are associated with decreased risk of disease progression and death in non-cirrhotic patients with primary biliary cholangitis

Background/aims We evaluated whether statins in non-cirrhotic patients with primary biliary cholangitis (PBC) might influence disease progression, including cirrhosis development, hepatic decompensation, all-cause mortality, liver-related death (LRD) and non-liver-related death (NLRD), as such data are missing.Materials and methods We retrospectively analyzed prospectively collected data in 507 non-cirrhotic PBC patients (445 females, age: 53 (16) years, follow-up: 85 (130) months) including 232 that received statins due to increased cardiovascular risk and 275 that had no treatment with statins during the follow-up.Results There were no significant differences between the two groups in baseline demographic, clinical and laboratory characteristics except for higher cholesterol, LDL and triglyceride levels and higher frequency of MASLD/MASH in statin users. No differences in treatment response to UDCA (GLOBE score, Paris II) were noted between the groups. Statin users had lower rate of cirrhosis development (3.4% vs. 8%; p=0.03), hepatic decompensation (0.4% vs 4.7%; p=0.003), lower all-cause mortality (3.9% vs. 16.4%; pConclusions Statins seem to independently associate with higher cirrhosis-free survival and lower overall and liver-related mortality in non-cirrhotic patients with PBC. Larger prospective studies are needed to confirm our novel data.