S0773 Association of Statins and NSAIDS With Flare of Inflammatory Bowel Diseases (IBD)

Abstract

INTRODUCTION: In animal models, statins (Hydroxymethylglutaryl-CoA (HMG-CoA) reductase inhibitors) have been shown to inhibit pro-inflammatory gene expression by blocking Nf-kB (Nuclear Factor kappa-light-chain-enhancer) signaling. Effect of statin on flare of Inflammatory bowel disease (IBD) has not been well studied. Statins also have antifibrotic activity which is unrelated to the anti-inflammatory effect of the drug. Previous studies on impact of Nonsteroidal anti-inflammatory drugs (NSAIDS) on IBD have shown increased as well as decreased flares. We aimed to look at whether use of statins and NSAIDS was associated with reduced rate of flares in patients of IBD, Ulcerative Colitis (UC) and Crohn’s Disease (CD). METHODS: We performed a retrospective cohort study on all patients in our IBD database after obtaining approval from Institutional review board (IRB). IBD patients exposed to statin and NSAIDS were compared to unexposed patients. Outcome was evaluated using Chi-square (X2) analysis. P < 0.05 was considered significant. RESULTS: Our study included 2978 patients. Of these, 1595 had UC, 1367 had CD and rest had IC (Indeterminate colitis). Six hundred sixty-eight patients had statin use and 2310 had no statin use. Statin use was associated with increased flare of IBD in general as well as strongly associated with UC flare (P = .042 and .005 respectively). There was no association between statin exposure and CD flare (P = .984). Exposure to NSAIDS was not associated with increased or decreased frequency of flares in IBD, including UC, CD, and IC (Table 1). CONCLUSION: Our observational analysis showed that statin use is associated with decreased flares of UC but not with CD. Anti-inflammatory effect of statin could be effective in reducing the inflammation seen in mucosa in UC. In CD, antifibrotic effect of the statins may help in prevention of transmural involvement of the gastrointestinal tract and reduce complications, including flares. NSAIDS exposure was not associated with flare of CD. Prospective and randomized control trial studies on effect of statins and NSAIDS on IBD are necessary in future.Table 1.: showing statin and NSAID exposure with IBD flares