“Prior studies have suggested that statins can decrease inflammation and may improve IBD in patients who already have the disease. To our knowledge, this is the first study to show that statin exposure in patients without IBD is associated with a decreased risk of developing Crohn’s disease and ulcerative colitis,” Dr. Ryan Ungaro of the Icahn School of Medicine at Mount Sinai in New York tells Reuters Health by email.
The study team used a large U.S. claims database to examine putative effects of statins on the risk of new onset IBD. Their analysis, published online June 14 in The American Journal of Gastroenterology, included more than 9,000 adults with Crohn’s disease (CD) or ulcerative colitis (UC) and some 46,000 matched controls.
Any statin exposure was associated with a significantly decreased risk of IBD (odds ratio, 0.68), CD (OR, 0.64) and UC (OR, 0.70). The effect was similar when stratified by type of statin and intensity of treatment. The apparent protective effect was strongest against CD in older patients.
Statins continued to be associated with reduced risk of new IBD diagnosis after controlling for potential confounders including use of antibiotics, hormone replacement therapy, oral contraceptives and cardiovascular medications, as well as comorbidities.
The lack of a dose-response relationship “may suggest that lower doses of statins may be sufficient at decreasing inflammation,” the authors say.
Statin exposure is a “potential new environmental factor that modulates the risk of IBD,” Dr. Ungaro tells Reuters Health. “It will also be interesting for future studies to explore if this effect in IBD is mediated through immunomodulatory properties or impact of statins on the vascular system.”
He adds, “Consideration should be given to studying statins as a potential add-on therapy in mild IBD. If our results are confirmed in other studies, statins may have a role as a preventative treatment for patients at high risk for developing IBD; however, further studies are needed to determine this.”
Strengths of the current analysis include the large nationally representative sample size. Limitations include use of retrospective data and use of prescriptions as a surrogate marker for patients actually taking the medication and the fact that the database did not include reliable information on potential confounders that may influence IBD risk, such as smoking, diet, early life exposures or family history of IBD.