{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T17:57:09Z","timestamp":1784397429242,"version":"3.55.0"},"reference-count":47,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Portal hypertension is the principal driver of cirrhosis decompensation, leading to heightened morbidity and mortality. While non\u2010selective beta\u2010blockers (NSBBs) remain the standard of care, up to 45% of patients fail to achieve sufficient portal pressure reduction. Statins have gained attention as a potential therapeutic agent for portal hypertension. We conducted a systematic review and meta\u2010analysis of randomised controlled trials (RCTs) to evaluate the impact of statins on portal pressure and cirrhosis\u2010related outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched five databases through November 2024 for RCTs evaluating statin therapy in adults with cirrhosis and clinically significant portal hypertension (CSPH). The primary outcome was HVPG reduction, assessed as an absolute decrease or the proportion achieving a haemodynamic response (HVPG reduction \u2265\u200920% from baseline or to \u2264\u200912\u2009mmHg). Secondary outcomes included variceal bleeding, ascites and mortality. Random\u2010effects meta\u2010analyses were performed using pooled mean differences (MDs) and risk differences (RDs) with 95% confidence intervals (CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six RCTs (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009492) were included. Statin therapy was associated with significant HVPG reduction (MD: 1.1\u2009mmHg; 95% CI: 0.44\u20131.77;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200938.7%) and higher hemodynamic response (RD: 0.24; 95% CI: 0.02\u20130.45;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200976.8%). No significant differences were seen in variceal bleeding, ascites or mortality. On subgroup analysis, HVPG benefit was limited to studies with short\u2010term follow\u2010up. In studies comparing statin plus NSBB to NSBB alone, the addition of statins further reduced HVPG.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Statins modestly lower HVPG in cirrhosis\u2010related portal hypertension and may be a useful adjunct to NSBBs. Larger trials are needed to assess long\u2010term clinical benefits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO registration number: CRD42025622478<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70326","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T07:49:12Z","timestamp":1756799352000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Statin Therapy and Portal Pressure Reduction in Cirrhosis: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1489-2850","authenticated-orcid":false,"given":"Eyad","family":"Abdulrazzak","sequence":"first","affiliation":[{"name":"Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6909-6328","authenticated-orcid":false,"given":"Butros","family":"Fakhoury","sequence":"additional","affiliation":[{"name":"Department of Medicine Virginia Commonwealth University Health  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Jaan","sequence":"additional","affiliation":[{"name":"Department of Medicine Rochester General Hospital  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Ebrahim","sequence":"additional","affiliation":[{"name":"Department of Medicine Ascension St. Joseph Hospital  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imad","family":"Alabdul Razzak","sequence":"additional","affiliation":[{"name":"Department of Medicine Tower Health\u2014Phoenixville Hospital  Phoenixville Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Shehadah","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology UHS Wilson Medical Center  Johnson City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7148-5450","authenticated-orcid":false,"given":"Leandro","family":"Sierra","sequence":"additional","affiliation":[{"name":"Department of Medicine Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5581-8702","authenticated-orcid":false,"given":"Hazem","family":"Abosheaishaa","sequence":"additional","affiliation":[{"name":"Ichan School of Medicine at Mount Siani  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elliot B.","family":"Tapper","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology University 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