Evaluation of the Effect of Rosuvastatin on Portal Hypertension and Variceal Bleeding in Children with Compensated Cirrhosis

Background: Portal hypertension, a complication of chronic liver disease in children, can lead to severe gastrointestinal bleeding and an increased need for hospitalization and endoscopic treatment, potentially resulting in death. Statins, known for their anti-inflammatory, antioxidant, and anti-fibrotic effects, are used in the treatment of many chronic diseases. This study aimed to investigate the effects of rosuvastatin on improving portal pressure and esophageal varices while reducing bleeding associated with these conditions in children with cirrhosis.Methods: This randomized clinical trial was conducted in children with compensated liver cirrhosis at Akbar Children's Hospital in Mashhad, Iran, between March 2023 and November 2024. Initially, endoscopy and Doppler ultrasound were performed on 32 patients aged 7–17 years. The control group received standard treatments for portal hypertension, while the intervention group received rosuvastatin tablets in addition to standard treatments. After a 6-month period, Doppler ultrasound and control endoscopy were repeated. All clinical, laboratory, sonographic, and endoscopic data were analyzed by a statistician, and the results were reported.Results: The study included 32 children with cirrhosis (16 in the control group and 16 in the intervention group). The number of cases showing a decrease in ultrasonographic parameters of portal hypertension (SA-RI and RRA-RI) was higher in the rosuvastatin group (p=0.14 and 0.37). The grades of esophageal varices decreased by 26.7% and 20% in the control and rosuvastatin groups, respectively (p=0.66). Esophageal variceal bleeding occurred in 13.3% of cases in the control group and in 25% of cases in the rosuvastatin group,with no statistically significant difference between the two groups (p=0.41).Conclusion: Over the 6-month follow-up period, rosuvastatin did not demonstrate a beneficial effect in reducing portal hypertension and variceal bleeding in children with compensated liver cirrhosis.

Evaluation of the Effect of Rosuvastatin on Portal Hypertension and Variceal Bleeding in Children with Compensated Cirrhosis Keywords:

Pediatric Cirrhosis , Portal Hypertension , Statin