Statin use in asthmatics on inhaled corticosteroids is associated with decreased risk of emergency department visits

Abstract

Objective:

Statins are hypothesized to have beneficial effects in asthma management through their pleiotropic anti-inflammatory effects. Several studies have examined this relationship, but have yielded conflicting results. This study investigates the effect of statin use on asthma-related hospitalizations and/or emergency department (ED) visits, and whether this relationship varies by concomitant inhaled corticosteroid (ICS) in a large cohort of asthma patients.

Methods:

Subjects with asthma, a recent history of asthma exacerbation, and who were 18 years or older were selected from the population-based Medco Health Solutions administrative database over a 1 year period. Prescription claims for statins and asthma medications, and asthma-related hospitalizations and/or ED visits were ascertained over a 12 month follow-up period. Subjects were stratified into two groups based on their ICS use.

Results:

A total of 3747 ICS users and 2905 non-ICS users were included in this study. Statin users represented 21% of ICS users and 11% of non-users. Among ICS users, statin use was significantly associated with decreased odds of asthma-related ED visits (OR = 0.77, 95% CI 0.64–0.94, p = 0.008), but not with asthma-related hospitalizations (OR = 1.09, 95% CI 0.92–1.30, p = 0.31). No significant associations were found among non-ICS users (for asthma-related ED visits: OR = 0.92, 95% CI 0.57–1.49, p = 0.73; asthma-related hospitalizations: OR = 1.10, 95% CI 0.85–1.41, p = 0.48). The statistical interactions between ICS and statin use on asthma-related hospitalizations and/or ED visits were not significant.

Conclusion:

Statin use is associated with fewer ED visits in asthma patients who are using ICS.

Keywords::

• Asthma
• Exacerbation
• Inhaled corticosteroids
• Statins

Transparency

Declaration of funding

This work was funded by National Institutes of Health grants U01 HL65899 and R01 HL92197. This paper is subject to the NIH Public Access Policy (http://publicaccess.nih.gov).

Declaration of financial/other relationships

S.T.W. has served as an unpaid consultant for GlaxoSmithKline, Genetech, Novartis, Merck, Genome Network Sciences and Schering Plough. S.L.C. serves as a paid HE/OR advisor to Novo Nordisk, and has previously been employed by Medco Research Institute LLC, a wholly owned subsidiary of Express Scripts Holding Co. Inc. He is currently employed by Sanofi-Aventis. A.C.W. has received grant funding from the NIH. E.S. is an employee of Novartis Pharmaceuticals. S.M.T., V.H., S.G., A.A.L., and A.C.W. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.