Ursodeoxycholic acid-enhanced efficiency and safety of statin therapy in patients with liver, gallbladder, and/or biliary tract diseases: the RACURS study

• Published in: Terapevtic̆eskii arhiv Vol. 86; no. 12; pp. 48 - 52
• Main Authors: Martsevish, S Iu, Kutishenko, N P, Drozdova, L Iu, Lerman, O V, Nevzorova, V A, Reznik, I I, Shavkuta, G V, Iakhontov, D A, RACURS study group
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) "Consilium Medicum" Publishing house 2014
• Subjects: Adult; Aged; Aged, 80 and over; Biliary Tract Diseases - blood; Biliary Tract Diseases - drug therapy; Cardiovascular Diseases - blood; Cardiovascular Diseases - drug therapy; Cardiovascular Diseases - prevention & control; cardiovascular diseases concurrent with liver and gallbladder diseases; Drug Synergism; Drug Therapy, Combination; Gallbladder Diseases - blood; Gallbladder Diseases - drug therapy; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects; Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology; Liver Diseases - drug therapy; Middle Aged; Risk; statin therapy; Treatment Outcome; Ursodeoxycholic Acid - administration & dosage; Ursodeoxycholic Acid - adverse effects; Ursodeoxycholic Acid - pharmacology; ursodeoxycholic acid addition
• ISSN: 0040-3660; 2309-5342
• DOI: 10.17116/terarkh2014861248-52

To evaluate the efficiency and safety of using statins in combination with ursodeoxycholic acid (UDCA) in patients with this or another liver disease at high risk for cardiovascular events (CVE).
A register of 262 patients at high risk for CCE who needed statin therapy and have concomitant chronic liver and biliary tract diseases was created in 5 cities of the Russian Federation.
After addition of statins or adjustment of their doses, the patients were recommended to include UDCA into their therapy. Six months after stabilization of the dose of statins, the whole group showed a significant reduction in the levels of total cholesterol and low-density lipoprotein (LDL) cholesterol. Assessment of the laboratory parameters responsible for the safety of statin intake revealed no deterioration in the trend in the activity of alanine aminotransferase, aspartate aminotransferase, creatine phosphokinase, lactate dehydrogenase, as well as an increase in the serum level of bilirubin. The data obtained using a special questionnaire indicated that 196 patients had taken UDCA and 56 had not. The UDCA and non-UDCA subgroups did not differ in age, weight, or baseline lipid metabolic disturbances. An additional analysis showed that by the end of 6 months, the goal levels of LDL cholesterol in the UDCA and non-UDCA groups were reached in 37 and 20%, respectively (p = 0.01).
UDCA added to statin therapy in patients at high risk for CVE and concurrent liver diseases contributes to an additional reduction in total cholesterol and LDL cholesterol and prevents enhanced hepatic transaminase activities.