Park ChulHyoung, Jang Jae-Hyuk, Kim Chungsoo, Lee Youngsoo, Lee Eunyoung, Yang Hyoung-Mo, Park Rae Woong, Park Hae-Sim
Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea.
Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Republic of Korea.
J Allergy Clin Immunol Pract. 2024 Feb;12(2):399-408.e6. doi: 10.1016/j.jaip.2023.10.029. Epub 2023 Oct 20.
Blood lipids affect airway inflammation in asthma. Although several studies have suggested anti-inflammatory effects of statins on asthmatic airways, further studies are needed to clarify the long-term effectiveness of statins on asthma control and whether they are an effective treatment option.
To evaluate the long-term effectiveness of statins in the chronic management of adult asthma in real-world practice.
Electronic medical record data spanning 28 years, collected from the Ajou University Medical Center in Korea, were used to conduct a retrospective study. Clinical outcomes were compared between patients with asthma who had maintained statin use (the statin group) and those not taking statins, whose blood lipid tests were always normal (the non-statin group). We performed propensity score matching and calculated hazard ratios with 95% CIs using the Cox proportional hazards model. Severe asthma exacerbation was the primary outcome; asthma exacerbation, asthma-related hospitalization, and new-onset type 2 diabetes mellitus and hypertension were secondary outcomes.
After 1:1 propensity score matching, the statin and non-statin groups each included 545 adult patients with asthma. The risk of severe asthma exacerbations and asthma exacerbations was significantly lower in the statin group than in the non-statin group (hazard ratios [95% CI] = 0.57 [0.35-0.90] and 0.71 [0.52-0.96], respectively). There were no significant differences in the risk of asthma-related hospitalization or new-onset type 2 diabetes mellitus or hypertension between groups (0.76 [0.53-1.09], 2.33 [0.94-6.59], and 1.71 [0.95-3.17], respectively).
Statin use is associated with a lower risk of asthma exacerbation, with better clinical outcomes in adult asthma.
血脂影响哮喘患者的气道炎症。尽管多项研究表明他汀类药物对哮喘气道具有抗炎作用，但仍需进一步研究以明确他汀类药物对哮喘控制的长期有效性以及它们是否为有效的治疗选择。
评估他汀类药物在实际临床中对成人哮喘慢性管理的长期有效性。
利用韩国亚洲大学医学中心收集的28年电子病历数据进行回顾性研究。比较持续使用他汀类药物的哮喘患者（他汀类药物组）和血脂检测始终正常且未服用他汀类药物的患者（非他汀类药物组）的临床结局。我们进行了倾向评分匹配，并使用Cox比例风险模型计算了95%置信区间的风险比。严重哮喘加重是主要结局；哮喘加重、与哮喘相关的住院治疗以及新发2型糖尿病和高血压为次要结局。
经过1:1倾向评分匹配后，他汀类药物组和非他汀类药物组各纳入545例成年哮喘患者。他汀类药物组严重哮喘加重和哮喘加重的风险显著低于非他汀类药物组（风险比[95%置信区间]分别为0.57[0.35 - 0.90]和0.71[0.52 - 0.96]）。两组之间在与哮喘相关的住院治疗、新发2型糖尿病或高血压的风险方面无显著差异（分别为0.76[0.53 - 1.09]、2.33[0.94 - 6.59]和1.71[0.95 - 3.17]）。
使用他汀类药物与较低的哮喘加重风险相关，对成人哮喘具有更好的临床结局。
