Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Allergy and Clinical Immunology Research (ACIR) Centre, National Cheng Kung University, Tainan, Taiwan.
Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan; Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
J Allergy Clin Immunol Pract. 2018 Sep-Oct;6(5):1588-1595.e1. doi: 10.1016/j.jaip.2017.12.017. Epub 2018 Feb 6.
Statins have pleiotropic anti-inflammatory and immunomodulatory effects, yet the effect of statin use on asthma-related emergency department (ED) visits and hospitalizations has remained unclear, especially in Asian populations.
We sought to examine the effect of statin therapy on asthma-related ED visits and/or hospitalizations.
A cohort study was conducted using data from Taiwan's National Health Insurance Research Database from 2001 to 2013. A total of 117,595 adult patients with asthma were included. The outcomes were defined as asthma-related ED visits and/or hospitalizations. Multiple Cox proportional hazards models were applied to determine the effect of statin use on asthma-related ED visits and/or hospitalizations.
There were 3,417 asthma-related ED visits and/or hospitalizations among 117,595 subjects with asthma. Statin users were significantly less likely to experience asthma-related ED visits and/or hospitalizations (adjusted hazard ratio: 0.81; 95% confidence interval: 0.74-0.89) compared with nonstatin users. The risks of asthma-related ED visits and/or hospitalizations were decreased among those with a higher cumulative defined daily dose (DDD), greater average DDD, and longer cumulative-day users than the counterparts.
Our study suggests that statin use is associated with the decreased risk of asthma-related ED visits and/or hospitalizations in patients with asthma. A dose-response effect of statin use is also observed in this study. Therefore, future randomized clinical trials would be warranted to further evaluate the association.
他汀类药物具有多种抗炎和免疫调节作用，但他汀类药物使用对哮喘相关急诊就诊和住院的影响仍不清楚，尤其是在亚洲人群中。
我们旨在研究他汀类药物治疗对哮喘相关急诊就诊和/或住院的影响。
采用台湾全民健康保险研究数据库 2001 年至 2013 年的数据进行队列研究。共纳入 117595 例成年哮喘患者。结局定义为哮喘相关急诊就诊和/或住院。采用多 Cox 比例风险模型确定他汀类药物使用对哮喘相关急诊就诊和/或住院的影响。
在 117595 例哮喘患者中，有 3417 例哮喘相关急诊就诊和/或住院。与非他汀类药物使用者相比，他汀类药物使用者发生哮喘相关急诊就诊和/或住院的风险明显较低（调整后的风险比：0.81；95%置信区间：0.74-0.89）。与相应的非使用者相比，累积规定日剂量（DDD）较高、平均 DDD 较大和累积天数较长的使用者发生哮喘相关急诊就诊和/或住院的风险降低。
我们的研究表明，他汀类药物使用与哮喘患者哮喘相关急诊就诊和/或住院风险降低相关。在本研究中还观察到他汀类药物使用的剂量反应效应。因此，有必要进行未来的随机临床试验来进一步评估这种关联。
