Lin Guan-Ling, Lin Hsiu-Chen, Lin Hsiu-Li, Keller Joseph Jordan, Wang Li-Hsuan
School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.
Department of Pediatrics, School of Medicine, Taipei Medical University, Taipei, Taiwan.
Front Pharmacol. 2023 Feb 15;14:1096999. doi: 10.3389/fphar.2023.1096999. eCollection 2023.
To investigate the association between statin use and risk of gout in patients with hyperlipidemia. In this population-based retrospective cohort study, patients ≥20 years and diagnosed as having incident hyperlipidemia between 2001 and 2012 were identified from the 2000 Longitudinal Generation Tracking Database in Taiwan. Regular statin users (incident statin use, having 2 times and ≥90 days of prescription for the first year) and two active comparators [irregular statin use and other lipid-lowering agent (OLLA) use] were compared; the patients were followed up until the end of 2017. Propensity score matching was applied to balance potential confounders. Time-to-event outcomes of gout and dose- and duration-related associations were estimated using marginal Cox proportional hazard models. Regular statin use non-significantly reduced gout risk compared with irregular statin use (aHR, 0.95; 95% CI, 0.90-1.01) and OLLA use (aHR, 0.94; 95% CI, 0.84-1.04). However, a protective effect was noted for a cumulative defined daily dose (cDDD) of >720 (aHR, 0.57; 95% CI, 0.47-0.69 compared with irregular statin use and aHR, 0.48; 95% CI, 0.34-0.67 compared with OLLA use) or a therapy duration of >3 years (aHR, 0.76; 95% CI, 0.64-0.90 compared with irregular statin use and aHR, 0.50; 95% CI, 0.37-0.68 compared with OLLA use). Dose- and duration-dependent associations were consistent in the 5-year sensitivity analyses. Although statin use was not associated with a reduction in gout risk, the protective benefit was observed in those receiving higher cumulative doses or with a longer therapy duration.
探讨他汀类药物使用与高脂血症患者痛风风险之间的关联。在这项基于人群的回顾性队列研究中，从台湾2000年纵向世代追踪数据库中识别出年龄≥20岁且在2001年至2012年间被诊断为新发高脂血症的患者。比较了规律使用他汀类药物的患者（首次使用他汀类药物，第一年有2次及≥90天的处方）和两个活性对照[不规律使用他汀类药物和使用其他降脂药物（OLLA）]；对患者进行随访至2017年底。应用倾向评分匹配来平衡潜在的混杂因素。使用边际Cox比例风险模型估计痛风的事件发生时间结局以及剂量和疗程相关的关联。与不规律使用他汀类药物相比，规律使用他汀类药物对痛风风险的降低无显著意义（调整后风险比[aHR]，0.95；95%置信区间[CI]，0.90 - 1.01），与使用OLLA相比也是如此（aHR，0.94；95% CI，0.84 - 1.04）。然而，观察到累积限定日剂量（cDDD）>720时具有保护作用（与不规律使用他汀类药物相比，aHR，0.57；95% CI，0.47 - 0.69；与使用OLLA相比，aHR，0.48；95% CI，0.34 - 0.67），或治疗疗程>3年时具有保护作用（与不规律使用他汀类药物相比，aHR，0.76；95% CI，0.64 - 0.90；与使用OLLA相比，aHR，0.50；95% CI，0.37 - 0.68）。在5年敏感性分析中，剂量和疗程依赖性关联是一致的。虽然他汀类药物的使用与痛风风险降低无关，但在接受更高累积剂量或更长治疗疗程的患者中观察到了保护益处。
