Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
Departments of Otorhinolaryngology-Head & Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
J Allergy Clin Immunol Pract. 2021 Jul;9(7):2783-2791. doi: 10.1016/j.jaip.2021.04.014. Epub 2021 Apr 21.
Statins, which are a type of 3-hydroxy-3-methylglutaryl-CoA inhibitor, have multiple therapeutic effects, including anti-inflammatory and immunomodulatory properties. Despite positive preclinical data on statin use in patients with asthma, clinical trials and epidemiological studies have yielded conflicting results.
To evaluate the association between statin use and an asthma diagnosis in all participants and the effects of statins on asthma-related outcomes among patients with asthma using a national health screening cohort.
Patients with asthma and control participants matched for age group, sex, income, and region of residence were selected from the Korean National Health Insurance Service-Health Screening Cohort data. This case-control study comprised 88,780 people with asthma and the same number of control participants. Asthma exacerbation (AE) was defined as an emergency department visit, a history of hospitalization due to asthma, or the use of systemic steroids for 2 weeks. Conditional and unconditional logistic regression analyses were used to evaluate the effect of the previous use of statins on an asthma diagnosis or AE after adjusting for multiple covariates.
A significant association between a statin prescription and an asthma diagnosis was not observed in this cohort (adjusted odds ratio, 1.01; 95% CI, 0.98-1.03; P = .633 for 1 year of statin prescription). Among the patients with asthma, 16.54% (n = 14,687) were categorized into the AE group and the others (n = 74,093) were categorized into the no AE group. A statin prescription was associated with fewer AEs in patients with asthma (adjusted odds ratio, 0.89; 95% CI, 0.84-0.93; P < .001 for 1 year of statin prescription).
Statin use was associated with a reduced risk of asthma-related emergency department visits, hospitalizations, and systemic steroid use in patients with asthma in this cohort study.
他汀类药物是 3-羟基-3-甲基戊二酰辅酶 A 抑制剂的一种，具有多种治疗作用，包括抗炎和免疫调节特性。尽管他汀类药物在哮喘患者中的应用有积极的临床前数据，但临床试验和流行病学研究得出的结果却存在矛盾。
通过全国健康筛查队列，评估所有参与者中他汀类药物的使用与哮喘诊断之间的关联，以及他汀类药物对哮喘患者哮喘相关结局的影响。
从韩国国民健康保险服务-健康筛查队列数据中选择哮喘患者和年龄组、性别、收入和居住地区相匹配的对照组参与者。本病例对照研究包括 88780 名哮喘患者和相同数量的对照组参与者。哮喘加重（AE）定义为急诊就诊、因哮喘住院的病史或使用全身性类固醇治疗 2 周。采用条件和无条件逻辑回归分析，在调整了多个协变量后，评估他汀类药物的既往使用对哮喘诊断或 AE 的影响。
在该队列中，他汀类药物处方与哮喘诊断之间没有显著关联（调整后的优势比，1.01；95%置信区间，0.98-1.03；P =.633 用于 1 年的他汀类药物处方）。在哮喘患者中，16.54%（n = 14687）被归入 AE 组，其余（n = 74093）被归入无 AE 组。他汀类药物处方与哮喘患者 AE 减少相关（调整后的优势比，0.89；95%置信区间，0.84-0.93；P <.001 用于 1 年的他汀类药物处方）。
在本队列研究中，他汀类药物的使用与哮喘患者哮喘相关的急诊就诊、住院和全身性类固醇使用风险降低相关。
