Laboratory for Health Protection Research, National Institute for Public Health and Environment, Bilthoven, Netherlands.
Semin Arthritis Rheum. 2011 Dec;41(3):373-81. doi: 10.1016/j.semarthrit.2011.06.002. Epub 2011 Aug 24.
Several case reports of lupus-like syndrome suggest that statins could have triggered the development of this rare autoimmune disease. However, data on the association between statin use and lupus-like syndrome are scarce. We assessed whether there was an association between statin use and the occurrence of lupus-like syndrome.
A case/noncase study based on individual case safety reports listed in the World Health Organization global individual case safety reports database (VigiBase) was conducted. According to World Health Organization adverse reaction terminology, cases were defined as reports of lupus-like syndrome. Each case was matched with 5 noncases by age, gender, and time of reporting. Use of statins was classified according to the Anatomical Therapeutic Chemical classification code system. Covariates, ie, use of corticosteroids, immunosuppressive drugs, nonsteroidal anti-inflammatory drugs, antidepressants, antiepileptics, proton pump inhibitors, and cardiovascular drugs, were determined. Multivariate logistic regression was used to calculate the reporting odds ratios with 95% confidence intervals.
We identified 3362 reports of lupus-like syndrome as cases and 27,092 reports of other adverse drug reactions as noncases. Statins were more frequently reported as suspected drug in cases (3.2%) than in noncases (1.5%). After adjustment for several covariates, statins were associated with the reporting of lupus-like syndrome (reporting odds ratios 2.01; 95% confidence intervals 1.61-2.51).
We found an association between reporting of statins and lupus-like syndrome. Further studies are needed to confirm this finding in more detail and establish causality.
有几例狼疮样综合征的病例报告表明,他汀类药物可能引发了这种罕见的自身免疫性疾病。然而,关于他汀类药物使用与狼疮样综合征之间的关联的数据却很少。我们评估了他汀类药物使用与狼疮样综合征发生之间是否存在关联。
我们进行了一项基于世界卫生组织全球个体病例安全报告数据库(VigiBase)中列出的个体病例安全报告的病例/非病例研究。根据世界卫生组织不良反应术语,病例被定义为狼疮样综合征的报告。每个病例通过年龄、性别和报告时间与 5 个非病例相匹配。他汀类药物的使用根据解剖治疗化学分类系统进行分类。确定了协变量,即皮质类固醇、免疫抑制剂、非甾体抗炎药、抗抑郁药、抗癫痫药、质子泵抑制剂和心血管药物的使用情况。使用多变量逻辑回归计算 95%置信区间的报告比值比。
我们确定了 3362 例狼疮样综合征报告为病例,27092 例其他药物不良反应报告为非病例。他汀类药物作为可疑药物在病例中的报告频率(3.2%)高于非病例(1.5%)。调整了几个协变量后,他汀类药物与狼疮样综合征的报告相关(报告比值比 2.01;95%置信区间 1.61-2.51)。
我们发现他汀类药物的报告与狼疮样综合征之间存在关联。需要进一步的研究来更详细地证实这一发现并确定因果关系。