Premium
P4‐100: Statin use and the risk of Alzheimer's disease and amyotrophic lateral sclerosis: Insights from a health insurance database
Author(s) -
Riordan Henry J.,
Sutton Virginia K.,
Zdon Gary S.,
Anderson David R.,
Seeger John,
Schaeffer Jamie,
Moore Rodney J.
Publication year - 2008
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2008.05.2165
Subject(s) - amyotrophic lateral sclerosis , medicine , statin , disease , logistic regression , proportional hazards model
Background: The cholesterol-lowering statins are among the most commonly prescribed drugs in the US. A causative role for cholesterol metabolism has been suggested in the development of Alzheimer’s disease (AD), and epidemiologic studies have suggested that statins reduce the risk of AD. Conversely, treatment with statins, has been reported to be associated with an increased risk of developing amyotrophic lateral sclerosis (ALS). We examined de-identified claims data from a large US health insurer to quantify the association between statin use and the development of AD or ALS. Methods: Study 1. Plan members (minimum 2 years participation) ages 55 with a new diagnosis of AD between May 2002 and Nov 2007 were identified (N 24,259). For each of these AD patients, a corresponding age-, calendar time-, and sex-matched risk set (with a similar minimum 2 years preceding enrollment) was also identified. Conditional logistic regression was utilized to assess the prevalence of statin use (during the 2 years preceding ascertainment) among AD patients relative to the matched risk set. Study 2. Plan members (minimum 2 years participation) ages 40 with a new diagnosis of ALS between Jan 1996 and Aug 2007 were identified (N 1011). For each patient, a single age-, calendar time-, and sex-matched control was identified (with a similar minimum 2 years preceding enrollment). A matched analysis provided a summary (Mantel-Haenszel) association between statin use and ALS. Results: Study 1. Results suggested a slightly lower risk of AD associated with statin use that was statistically significant, but was not considered clinically meaningful (summary odds ratio 0.98, 95% CI 0.97-0.99; P .0003). Study 2. Contrary to previous reports, results indicated there was not an increased risk of ALS associated with statin use (summary odds ratio 0.91; 95% CI 0.72-1.16; P .4619). Conclusions: The present results indicate that prior statin use is statistically associated with a decreased risk for AD, but the effect is of questionable clinical relevance. There appeared to be no change in risk of ALS associated with statin use. The potential neuroprotective and/or deleterious effects of statin use in these disorders is modified by several factors including duration of use as well as concomitant illnesses and medications.