Published On: 6/15/2021

TARGET-NASH Study Finds Statins Underutilized in Patients with NAFLD and At-Risk of Heart Disease

DURHAM, N.C., June 15, 2021 /PRNewswire/ -- Just over half (56%) of patients enrolled in TARGET-NASH with non-alcoholic fatty liver disease (NAFLD) and with at least one indication for guideline-recommended use of a statin are taking one despite their higher risk of heart disease, according to new research published in Clinical Gastroenterology & Hepatology (doi: 10.1016/j.cgh.2021.03.031; epub ahead of print). The analysis from the long-term observational study TARGET-NASH was sponsored by Target RWE, a leading real-world evidence (RWE) solutions company for the healthcare industry.

Global prevalence of NAFLD is estimated at 25%, and diagnoses have increased over the past two decades.¹ This increasing prevalence, paired with high risk of heart disease that NAFLD patients face, sets the stage for a growing public health concern.

Statins are a class of medications commonly prescribed to reduce the risk of heart disease. But they are often under-prescribed among patients with liver disease due to concerns over causing further liver damage.^2,3 However, research has shown that statins are safe among patients with liver disease, including those with compensated cirrhosis,⁴ and use is associated with lower mortality, lower risk of further liver deterioration, and possibly lower hepatocellular carcinoma.^5,6 

"Providers are grappling with an aging population, paired with serious and comorbid chronic conditions like heart disease and NAFLD. This real-world evidence from the TARGET-NASH study provides much-needed insight into the course of treatment for patients with NAFLD who are at risk of cardiovascular disease," said Mary Thomson, MD, MSC, Assistant Professor of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota Medical School, and lead co-author.

"Our results found guideline-recommended statins remain underutilized and were not prescribed in 40% of NAFLD patients with clear indications," said Anna S. Lok, MD, Professor of Internal Medicine and Director of Clinical Hepatology, University of Michigan. "Educating providers and patients on statin safety and benefits to prevent cardiovascular disease, especially at-risk NAFLD patients, will be imperative in improving outcomes of patients with NAFLD who are at risk of both cardiovascular and liver-related mortality."

The TARGET-NASH manuscript assessed prevalence and patient factors associated with indicated statin use in patients with NAFLD, NASH, compensated cirrhosis, and decompensated cirrhosis. Results found older patients, including those with high cholesterol, diabetes, or history of cardiovascular disease, were more likely to be on a statin. Women were less likely to be on an indicated statin compared to men, and there was a smaller proportion of patients with cirrhosis using a statin compared to those with milder disease. Prevalence and factors associated with statin use among patients with non-alcoholic fatty liver disease in TARGET-NASH analyzed 2,214 patients across 60 U.S. sites with at least one statin indication.