Efficacy and Safety of Statins in MASLD and Other Chronic Liver Diseases

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease worldwide, with an estimated global prevalence of 38% in adults. MASLD confers a significant increase in morbidity and mortality due to its association with cardiovascular disease and progressive liver disease, including cirrhosis and hepatocellular carcinoma. Current treatment paradigms for MASLD are centred around lifestyle modification and weight loss, with a need for pharmacotherapeutic options. Given the strong relationship between MASLD and cardiovascular disease, there is an interest in evaluating the efficacy and safety of cardiovascular medications such as statins in liver disease. Statins are the most commonly prescribed lipid-lowering medication in the world, with an established role in reducing cardiovascular morbidity and mortality. Statins are currently under-prescribed in the MASLD patient population, yet there is growing interest in determining whether statins could be utilised to treat MASLD itself. This comprehensive review aims to explore the evidence regarding the use of statin therapy for conventional, lipid-lowering indications in patients with MASLD and its potential benefits for the treatment of MASLD and its complications.