Sherif M El-Refai1, Esther P Black1, Val R Adams2, Jeffery C Talbert2, Joshua D Brown3. 1. Department of Pharmaceutical Sciences, University of Kentucky College of Pharmacy, Lexington, KY, USA. 2. Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY, USA. 3. Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY, USA; Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, USA. Electronic address: joshua.brown@ufl.edu.
Abstract
BACKGROUND: Statins have been shown to have a protective effect for venous thromboembolism (VTE) in the general population. This study sought to assess the association between statins and the risk for cancer-associated deep vein thrombosis (DVT) and pulmonary embolism (PE). METHODS: Patients with newly diagnosed cancer were followed for up to one year in a healthcare claims database (2010-2013). Three treatment groups included statin users, non-statin cholesterol lowering medication users, and an untreated group with pre-existing indications for statin therapy (hyperlipidemia, diabetes, or heart disease). Propensity score matched groups were compared using competing risks survival models for DVT and PE outcomes reporting the hazard ratios (HR) between the treatment groups. Sensitivity analyses assessed the influence of age and individual medications. RESULTS: The total cohort included 170,459 patients, which, after matching, were similar on baseline characteristics. The overall model showed a statistically significant protective effect for statins compared to no treatment attributed only to leukemia for DVT (HR=0.77, 95% CI 0.61-0.99) and colorectal cancers for PE (HR=0.80, 95% CI 0.64-0.99) in stratified analyses. There were generally no differences in outcomes between statins and non-statins and no individual statin use showed results different from the class effect. CONCLUSIONS: In this propensity score matched sample of patients with cancer, statins were shown to have a small protective effect in some cancers for DVT or PE compared to no treatment and little difference compared to an active control group. The lack of effect was consistent across statins and was also not found for any of the sensitivity analyses included.
BACKGROUND: Statins have been shown to have a protective effect for venous thromboembolism (VTE) in the general population. This study sought to assess the association between statins and the risk for cancer-associated deep vein thrombosis (DVT) and pulmonary embolism (PE). METHODS:Patients with newly diagnosed cancer were followed for up to one year in a healthcare claims database (2010-2013). Three treatment groups included statin users, non-statin cholesterol lowering medication users, and an untreated group with pre-existing indications for statin therapy (hyperlipidemia, diabetes, or heart disease). Propensity score matched groups were compared using competing risks survival models for DVT and PE outcomes reporting the hazard ratios (HR) between the treatment groups. Sensitivity analyses assessed the influence of age and individual medications. RESULTS: The total cohort included 170,459 patients, which, after matching, were similar on baseline characteristics. The overall model showed a statistically significant protective effect for statins compared to no treatment attributed only to leukemia for DVT (HR=0.77, 95% CI 0.61-0.99) and colorectal cancers for PE (HR=0.80, 95% CI 0.64-0.99) in stratified analyses. There were generally no differences in outcomes between statins and non-statins and no individual statin use showed results different from the class effect. CONCLUSIONS: In this propensity score matched sample of patients with cancer, statins were shown to have a small protective effect in some cancers for DVT or PE compared to no treatment and little difference compared to an active control group. The lack of effect was consistent across statins and was also not found for any of the sensitivity analyses included.
Authors: M Schmidt; S C Cannegieter; S A Johannesdottir; O M Dekkers; E Horváth-Puhó; H T Sørensen Journal: J Thromb Haemost Date: 2014-06-19 Impact factor: 5.824
Authors: Cu Dinh Nguyen; Charlotte Andersson; Thomas Bo Jensen; Anne Gjesing; Anne-Marie Schjerning Olsen; Carolina Malta Hansen; Harry Büller; Christian Torp-Pedersen; Gunnar H Gislason Journal: BMJ Open Date: 2013-11-07 Impact factor: 2.692
Authors: Ye Sel Kim; Moo-Seok Park; Jun-Hwa Lee; Jong-Won Chung; Mi Ji Lee; Chi Kyung Kim; Jin-Man Jung; Kyungmi Oh; Oh Young Bang; Geong-Moon Kim; Ji-Mi Choi; Juneyoung Lee; Chin Sang Chung; Kwang Ho Lee; Woo-Keun Seo Journal: Front Neurol Date: 2018-04-24 Impact factor: 4.003