Impact of Chronic Statins Use on the Development of Esophagitis in Patients with Gastroesophageal Reflux Disease.

Tawfik Khoury,Wisam Sbeit,Wiliam Nseir,Hana Amara,Mohamed Jabaren,Abdulla Watad,Amir Mari,Mahmud Mahamid

doi:10.1155/2019/6415757

Abstract

Background and Aims We aimed to assess whether chronic statins used (> 6 months) were protective of the development of esophagitis in patients with gastroesophageal reflux disease. In the presence of esophagitis, complications such as strictures, Barrett's esophagus, and adenocarcinoma were the most common. Statins, lipid lowering drugs with a pleiotropic effect, are recently implicated in various pathologies. Nevertheless, the possible impact of statins in esophagitis development has never been assessed. Methods We performed a retrospective, cross-sectional, single center study that included 4148 gastroesophageal reflux disease patients from 2014 and 2018 at EMMS Nazareth Hospital. We divided the patients into 5 groups. The groups were split into positive control group, which was the nonesophagitis group, and the other 4 groups were A-D (as per Los Angeles classification). Results Overall, out of the 4148 patients included, 48% were males and 2840 patients were in the control group. In groups A, B, C, and D there were 818, 402, 72, and 16 patients, respectively. Logistic regression analysis revealed that chronic statins usage is protective by preventing development esophagitis (OR 0.463 [95%CI 0.370–0.579], p < 0.0001). NSAIDS use, Hiatus hernia, and H. pylori were promoting factors (OR, 1.362, 1.779, and 1.811; 95% CI, 1.183-1.569, 1.551-2.040, and 1.428-2.298; P<0.0001, P<0.0001, and P<0.0001, respectively). Conclusion Using chronic statins was protective to the development of esophagitis among GERD patients. Our findings of potential clinical application mandate further randomized controlled trials to better assess the impact of statins on esophagitis.

Highlights

Gastroesophageal reflux disease (GERD) is chronic condition characterized by exacerbation and remission pattern [1, 2]
We aimed to investigate whether the use of chronic statin impacts the development and the severity grade of esophagitis in GERD patients
The prevalence of GERD in the western countries is estimated to be of 8%–33% and involves all age groups as it is associated with massive economic burdens and health resources consumption, mainly due to medication prescriptions and diagnostic procedures [21, 22]

Summary

Introduction

Gastroesophageal reflux disease (GERD) is chronic condition characterized by exacerbation and remission pattern [1, 2]. The spectrum of endoscopic findings varies and may range from nonerosive reflux disease (NERD) which is the most common endoscopic presentation of GERD to erosive esophagitis. The latter entity is further segmented, according to the severity of esophageal mucosal damage, and ranges from minimal mucosal changes such as breaks passing through erosions, ulcers, stricture formation, and malignant changes. We aimed to assess whether chronic statins used (> 6 months) were protective of the development of esophagitis in patients with gastroesophageal reflux disease. Using chronic statins was protective to the development of esophagitis among GERD patients. Our findings of potential clinical application mandate further randomized controlled trials to better assess the impact of statins on esophagitis

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Conclusion