Statins for Chronic Liver Disease and the Need for Randomized Controlled Trials

A large body of data shows that statins offer potential benefits in patients with chronic liver disease.1 However, most of the supportive clinical evidence stems from observational studies or from randomized trials that rely on surrogate outcomes, such as portal pressure.2,3 So far, the BLEPS trial4 stands out as the only fully published randomized trial evaluating clinical outcomes. This trial included patients with cirrhosis and a previous variceal hemorrhage and compared simvastatin with placebo (in addition to standard of care).