Statin use correlates with reduced risk of chronic osteomyelitis: a nationwide case–control study in Taiwan

Abstract

Background/objective: Potential association between prior statin use and chronic osteomyelitis is examined.

Methods: A nationwide case–control study was conducted based on data taken from the Taiwan National Health Insurance program. The case group includes 2338 subjects aged 20–84 years newly diagnosed for chronic osteomyelitis from 2000 to 2013; the control group included 2338 randomly selected subjects without chronic osteomyelitis matched for sex, age, and index year. Statin use was respectively defined as “current”, “recent” or “past” if the most recent statin prescription was filled <3 months, 3–6 months or ≥6 months prior to the chronic osteomyelitis diagnosis. Relative risk of chronic osteomyelitis associated with statin use was measured by the odds ratio (OR) with 95% confidence interval (CI) using the conditional logistic regression model.

Results: After controlling for potential confounders, the adjusted ORs of chronic osteomyelitis were 0.57 for subjects with current statin use (95% CI 0.45, 0.72), 0.80 for subjects with recent statin use (95% CI 0.48, 1.33), and 1.00 for subjects with past statin use (95% CI 0.83, 1.20), compared patients with no prior statin use. In further analysis, the adjusted ORs of chronic osteomyelitis were 0.70 for subjects with cumulative statin use <12 months (95% CI 0.47, 1.07), and 0.56 for subjects with cumulative statins use ≥12 months (95% CI 0.41, 0.77), compared with those with no prior statin use.

Conclusions: Current statin use is associated with reduced concurrent diagnosis of chronic osteomyelitis, particularly for a cumulative statin use ≥12 months.

Keywords:

• Chronic osteomyelitis
• statins
• Taiwan National Health Insurance Program

Transparency

Declaration of funding

This study was supported in part by Taiwan Ministry of Health and Welfare Clinical Trial Center (MOHW106-TDU-B-212-113004), China Medical University Hospital, Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10601010036), Taiwan Clinical Trial Consortium for Stroke (MOST 106-2321-B-039-005), Tseng-Lien Lin Foundation, Taichung, Taiwan, Taiwan Brain Disease Foundation, Taipei, Taiwan, and Katsuzo and Kiyo Aoshima Memorial Funds, Japan. These funding agencies did not influence the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author contributions: H.-F.L. and K.-F.L. planned and conducted this study, participated in the data interpretation, and critically revised the article. C.-M.C. and C.-L.L. conducted the data analysis and critically revised the article. S.-W.L. planned and conducted this study, contributed to the conception of the article, initiated the draft of the article, and critically revised the article.

Declaration of financial/other relationships

H.-F.L., K.-F.L., C.-M.C., C.-L.L. and S.-W.L. 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 on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgement

The authors thank the National Health Research Institute in Taiwan for providing us with the insurance claims data.