Annika Bergquist receives SEK 19 million in research support from the Swedish Research Council

The study Annika is leading will investigate whether a certain type of drug (statins) can reduce the risk of liver failure and liver cancer in primary sclerosing cholangitis (PSC)

What is the research grant you received?

“I have received a grant from the Swedish Research Council as a contribution to the research environment in clinical treatment research. The call aims to strengthen clinical research in Sweden by supporting studies conducted in several regions/universities across the country,” says Annika Bergquist, PI of the study and researcher at the Department of Medicine, Huddinge.

Tell us about your project!

“New studies on chronic liver disease other than PSC have shown that treatment with lipid-lowering drugs (statins) may reduce the risk of liver failure but also reduce the risk of liver cancer. We have recently conducted a study of drug use for PSC using data from various Swedish registers. The results show a correlation between statin treatment for PSC and prognosis, with a halved risk of death and the need for liver transplantation in those treated with statins. Statins inhibit cholesterol synthesis and thereby the formation of toxic bile acids, which are believed to be significant for the progression of PSC.

Furthermore, statins can be anti-inflammatory and can reduce the oxidative stress found in the liver in chronic liver disease. Based on these findings, we now wish to investigate whether statins really improve the PSC prognosis, by performing a randomised placebo-controlled study comparing atorvastatin with a placebo, with regard to the effect on survival, liver transplantation and cancer development,” says Annika Bergquist.

Who is taking part in the study?

“The study is conducted within the framework of a national network for the study of liver diseases (SweHep). We have worked together for more than 20 years and, through an ongoing observation of patients with PSC, have already identified appropriate PSC patients. We have also created the infrastructure necessary to conduct the study. We also cooperate with the patient association PSC Sweden. Patients with PSC from all over the country will be offered the chance to participate in the study. They receive treatment with the drug atorvastatin or a placebo, one tablet per day for five years. Annual follow-ups with checks for adverse reactions, samples and x-rays are carried out, and this follow-up corresponds to the regular follow-up recommended for patients suffering with PSC."

Which patient groups will benefit from the research and how?

“Patients with primary sclerosing cholangitis (PSC) are eligible to participate. PSC is a chronic liver disease that usually affects younger people with concomitant chronic inflammation of the intestine. The cause of PSC is unknown and the disease involves chronic inflammation around the bile ducts of the liver. The liver’s various functions gradually deteriorate and after 15 to 20 years, the majority of patients have developed liver cirrhosis along with liver failure and have needed life-saving treatment involving a liver transplant or have died. Bile duct cancer affects 15 to 20 per cent of patients with PSC and can occur at anytime during the course of the disease. Bile duct cancer with PSC may only be cured by liver transplant, provided it is detected in its early stages. No medical treatment exists that can slow the progression of cirrhosis or prevent cancer development. If we can find a way to slow down the progression of the disease and reduce the risk of cancer, it would be fantastic.”