TOPLINE:

Patients who started statin therapy after the diagnosis of Crohn’s disease (CD) had a lower risk for intestinal stricture formation than those who started other non-statin medications.

METHODOLOGY:

• Intestinal strictures are associated with substantial morbidity in patients with CD, with no approved therapies available for their prevention. Prior studies have shown anti-inflammatory and antifibrotic effects of statins in other conditions, but clinical evidence for preventing strictures is lacking.
• Researchers conducted a retrospective cohort study to evaluate whether starting statins after the diagnosis of CD was associated with a reduced risk for stricture development.
• They included patients newly diagnosed with CD using data from two US cohorts: the EVERSANA cohort based on electronic health records (January 2010-January 2024) and the Merative cohort based on administrative data (January 2007-December 2021).
• Patients who started taking statins within 6 months of inclusion in the respective cohorts and had a prescription for at least 6 months were propensity score matched with those who started taking any non-statin medications.
• The primary outcome was the development of a new stricture, defined as a clinical visit or hospitalization for intestinal obstruction or undergoing stricture-related procedures. The mean follow-up duration was roughly 3-4 years in both cohorts.

TAKEAWAY:

• The EVERSANA cohort included 1208 statin users (mean age, 58.6 years; 56.2% female) matched with an equal number of non-statin users. The Merative cohort included 9577 statin users (mean age, 54 years; 48.7% female) matched with an equal number of non-statin users.
• Statin users had a 28% lower risk of developing strictures in the EVERSANA cohort (P = .043) and a 29% lower risk in the Merative cohort than non-statin users (P ≤ .001).
• Statin use for 12-24 months (hazard ratio [HR], 0.84; 95% CI, 0.72-0.97) and more than 24 months (HR, 0.67; 95% CI, 0.61-0.73) was independently associated with a lower risk for stricture development, while statin use between 6 and 12 months had no significant effect.
• Female sex was independently associated with a reduced risk for stricture development, whereas older age at study inclusion was associated with an increased risk (P < .001 for both).

IN PRACTICE:

“[The study] findings suggest that statin use may confer benefit even among patients with moderate-to-severe disease, although this cannot be definitively established in a population-based cohort,” the authors of the study wrote.

“[The] findings, if confirmed prospectively, could have immediate implications for risk stratification and secondary prevention in CD,” they added.

SOURCE:

The study was jointly led by Abhishek Dimopoulos-Verma, MD, and Chiraag Kulkarni, MD, Stanford University, Palo Alto, California. It was published online in the Journal of Crohn’s and Colitis.

LIMITATIONS:

The study was retrospective in nature and could not eliminate all biases despite propensity score matching. Statin users were older and had more cardiovascular comorbidities. Many measures of inflammation were missing, CD subtypes were not recorded, and strictures may have been misclassified.

DISCLOSURES:

The study received a grant from the Leona M. and Harry B. Helmsley Charitable Trust to Stanford University. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.