Use Of Oral Statins Research Articles

Association of Meibomian Gland Dysfunction with Oral Statin Use.

This retrospective cross-sectional study aimed to determine the association of oral statin use, dry eye disease (DED), and meibomian gland dysfunction (MGD). A total of 93 subjects were included and divided into two groups: statin users (n = 45) and nonstatin users (n = 47). Significant differences were observed in the total cholesterol (p = 0.013), low-density lipoprotein (LDL) (p = 0.005), and meiboscore (p = 0.000) levels between the two groups. For stratified analysis, the statin group was divided into subgroups according to the type or dose of statin and total duration of statin use. However, there were no differences in clinical features between the subgroups. In multiple regression analysis, meiboscore was significantly associated with age (slope = 0.05, p = 0.00) and statin use (slope = −1.19, p = 0.00), with an R2 of 0.44. Thus, older adults and participants who do not use statin appeared to have higher scores. In conclusion, although the mechanism is unclear, statins may exert a protective effect on the meibomian gland. Further lipidomic studies are required to determine the pharmacological effects of statins on the meibomian gland and other meibum components.

Effect of oral statin use on mitomycin-C augmented trabeculectomy outcomes

PurposeThe effect of statins on wound healing is controversial, and their effect on trabeculectomy outcomes remains unclear. This study aimed to examine the relationship between oral statin use and trabeculectomy outcomes.MethodsMedical records of patients who underwent primary mitomycin-C augmented trabeculectomy with 2 years of follow-up were reviewed. Pre- and postoperative intraocular pressures (IOP) and numbers of medications, subconjunctival 5-fluorouracil (5-FU) injections, and bleb-needling procedures were compared between statin users and nonusers. Failure was defined as an eye that failed to achieve a 20% lowering of IOP from baseline or had an IOP > 21 mm Hg, as well as an eye that required further surgical intervention, developed hypotony, or had no light perception visual acuity.ResultsIn total, 158 subjects were enrolled, with 47 eyes from statin users and 111 eyes from statin nonusers. The 24-month cumulative probability of failure was 78.7% for statin users and 60.4% for nonusers (P = .013). Cox proportional-hazards modeling showed a significantly higher hazard risk in statin users (adjusted hazard ratio 1.61, P = .026). There were no significant between-group differences in mean IOPs or number of medications (both P > .05) at 24 months. Multivariable Poisson regression analysis that statin use was associated with increased numbers of 5-FU injections (P = .014) and bleb-needling procedures (P = .031).ConclusionsThis study demonstrated that oral statin use was associated with higher rates of trabeculectomy failure and increased numbers of 5-FU injections and bleb-needling procedures.

Association of dyslipidaemia and oral statin use, and dry eye disease symptoms in the Blue Mountains Eye Study.

There is limited literature on oral statin use and its association with dry eye. To analyse the association between dyslipidaemia, use of oral statin drugs, and symptoms of dry eye disease (DED) among older adults. Population-based study. Participants of the Blue Mountains Eye Study III (BMESIII), a large cohort study in suburban Sydney, aged 60 years or older (mean age = 74, range = 60-97, n = 1680) were analysed. Information on DED symptoms and statin use were obtained from an interviewer-administered questionnaire. Serum lipid profiles were determined from fasting blood tests. The association of various DED symptoms, as well as their number and their severity, with dyslipidaemia and oral statin intake was evaluated. At least one DED symptom was reported in 52% (n = 1029) of the population. Patients with hypercholesterolaemia (>5.5 mmol/L) did not report more DED symptoms than those without hypercholesterolaemia. Neither serum high-density lipoprotein nor low-density lipoprotein levels were associated with any DED symptoms. Patients taking oral statins were more likely to report one or more moderate to severe symptoms of DED (odds ratio: 2.054, 95% confidence interval: 1.281-3.295). The association between oral statin use and presence of moderate to severe DED symptomatology is a novel finding that deserves further mechanistic and clinical correlation in order to determine its potential, or lack thereof, for the management of dry eye.

The influence of oral statin medications on progression of glaucomatous visual field loss: A propensity score analysis

ABSTRACTPurpose: The purpose of this study was to examine the association between oral statin use and the progression of open angle glaucoma.Methods: Medical records of 847 Veterans were reviewed to collect statin use history, record demographic and comorbid medical conditions, and review visual fields. Visual field progression was judged by an ophthalmologist masked to statin use history. Progression rates in a propensity score matched cohort were compared between statin users and nonusers using McNemar’s test with the propensity model derived using associated medical and demographic factors.Results: The mean length of observation was 1324 days with a standard deviation of 464 days. Thirty-one per cent of Veterans demonstrated glaucomatous progression in at least one eye, 49% did not demonstrate progression, and 20% were indeterminate. Approximately 74% of subjects had previously used a statin, with this group having heavier burdens of several comorbid medical conditions and less severe baseline glaucoma than nonusers. The matched cohort was 196 statin users and 196 nonusers, each with similar baseline characteristics (standardised differences <0.10). Progression rates were 35% for statin users compared to 56% for nonusers in the matched cohort (McNemar’s p<0.001).Conclusions: In this population of Veterans, glaucoma patients with any history of statin use have lower visual field progression rates than statin nonusers.

The effect of statins on severity of psoriasis: A systematic review.

Psoriasis is becoming increasingly recognized as a chronic systemic inflammatory disease. Statins are generally well-tolerated drugs with pleiotropic effects including decreasing inflammation and may have the potential to reduce psoriasis severity. To examine whether oral statins reduce the severity of psoriatic skin disease. We searched MEDLINE, EMBASE and adapted for Google Scholar, Cochrane Central Register for Controlled Trials and Clinical trials.gov to January 6, 2016. We primarily examined randomized controlled trials that assessed the change in PASI score over a follow-up period of at least 8 weeks, for participants with an established diagnosis of psoriasis taking an oral statin versus placebo or other active treatment. Beyond this, we also examined other interventional studies that investigated the effect of statins on psoriasis severity using other designs. We extracted efficacy and adverse event data. The two study authors examined issues of study quality and study inclusion independently. Three studies were identified which measured the change in psoriasis severity using PASI, comparing statin with placebo or standard therapy alone in a prospective, randomized study design; these showed conflicting results. However, among the excluded studies, majority of which used a single arm, non-placebo controlled study design, most showed an improvement in PASI scores after statin use. Included studies were of limited sample size and quality. They were not amenable to pooled analysis. This review highlights the paucity of high quality, randomized, double-blinded, placebo-controlled trials investigating the effects of statins on psoriasis severity using clinically objective measures. There is insufficient evidence that the use of oral statins as an adjunctive therapy can reduce the severity of psoriasis.

Metabolic syndrome: new therapeutic approaches

In the last three decades in the United States the prevalence of overweight/obesity in pediatric population has more than tripled, causing the onset also in pediatric age of diseases previously considered exclusively of adults, such as metabolic syndrome (MetS) [1]. MetS represents a cluster of cardiometabolic abnormalities, including visceral obesity, dyslipidemia, hypertension and diabetes mellitus type 2 (T2DM) (Table ​(Table1).1). The prevalence of pediatric MetS ranged from 2% to 9% in the general population and from 12% to 44% in obese children, depending of definition used [1]. Several evidences suggest that the metabolic derangements observed in children may have a worrisome repercussion early on their health in adulthood [2,3]. Table 1 Diagnostic criteria for metabolic syndrome in children and adolescents Lifestyle modification, represented by the association among regular physical exercise and a balanced diet appropriate for age, is the most important therapeutic approach in children and adolescent with obesity and risk factors for MetS [4]. Behavioral intervention is mandatory but, in many cases, it is difficult to achieve or not sufficient and most pediatric patients require pharmacologic therapy early in their disease course. At the present time, the vast majority of drugs needed to treat insulin-resistance, hypercholesterolemia, hypertension are off-label in pediatric setting, although several studies demonstrated that pharmacological treatment for pediatric obesity and its related comorbidities are necessary [5]. Regarding dyslipidemia, the use of oral statins is reserved for children older than 10 years of age that, while on diet, continue to have dyslipidemia associated to family history for early cardiovascular disease (CVD) or additional risk factors. Metformin is the only drug approved for treatment of impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) in children. Several studies demonstrated its efficacy in ameliorating gluco-insulinemic profile; moreover, it has been reported a moderately effect on body weight in obese children. Anti-hypertensive drugs, such as angiotensin-converting-enzyme inhibitors (ACEIs), angiotensin-receptor blockers (ARBs), calcium channel blockers (CCBs), and beta-blocking agents are used in pediatric patients and the choice of drug class is made on the basis of clinical characteristics of the single patient. The core of treatment of pediatric MetS is abdominal obesity. Currently no pharmacological approach to obesity is accepted for pediatric patients. Bariatric surgery has been considered a successful treatment for MetS in obese adults in term of weight loss and decrease of mortality rate. This procedure has been used also in carefully selected obese adolescents and the outcomes seem to be similar to those for adults. However, further studies are needed to better select the patients to surgically treat and define efficacy and safety of bariatric surgery in pediatric MetS.

Effect of Statins on Cholesterol Crystallization and Atherosclerotic Plaque Stabilization

Pleiotropic effects of statins have not been fully elucidated. Recently we demonstrated that cholesterol expands when crystallizing and may trigger plaque rupture. The present study evaluated the potential direct effects of statins in altering cholesterol crystallization as a possible mechanism for plaque stabilization independent of cholesterol lowering. Cholesterol powder was dissolved in oil with and without pravastatin, simvastatin, or atorvastatin (10 to 90 mg) and then allowed to crystallize to measure peak volume expansion (ΔVE) in graduated cylinders. Effect of ΔVE on fibrous membrane damage was also evaluated. Human coronary, carotid, and peripheral arterial plaques (65 plaques from 55 patients) were incubated with statin or saline solution using matched plaque segments to evaluate direct effects of statins on preformed crystals. Also, the effect of in vivo use of oral statins on crystal structure was examined by scanning electron microscopy and crystal content in plaques scored from 0 to +3. For all statins, ΔVE decreased significantly in a dose-dependent fashion (0.76 ± 0.1 vs 0 ml at 60 mg, p <0.001). By scanning electron microscopy crystal structure with statins had loss of pointed tip geometries, averting fibrous membrane damage. Cholesterol crystal density was markedly decreased and appeared dissolved in human plaques incubated with statins (+2.1 ± 1.1 vs +1.3 ± 1.0, p = 0.0001). Also, plaques from patients taking oral statins compared to controls had significantly more dissolving crystals (p = 0.03). In conclusion, statins decreased ΔVE by altering cholesterol crystallization and blunting sharp-tipped crystal structure and dissolving cholesterol crystals in human arteries in vivo and in vitro, providing plaque stabilization.

Statins and other cholesterol-lowering medications and the presence of glaucoma.

To explore whether oral statin and other antihyperlipidemic medications are associated with open-angle glaucoma. The administrative clinical databases maintained at the Veterans Affairs Medical Center, Birmingham, Ala, were used to conduct a matched case-control study. Cases were all male patients aged 50 years and older with a new diagnosis of glaucoma on an outpatient or inpatient visit during the period January 1, 1997, through December 31, 2001. Ten control subjects were matched to each case according to age (within 1 year). Prescription files were assessed for statin use as well as additional medications to lower cholesterol levels. Information on comorbid medical conditions was also obtained. Conditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Longer duration of statin use was associated with a lower risk of open-angle glaucoma (P for trend =.04) primarily among subjects with 24 months or more of use (OR, 0.60; 95% CI, 0.39-0.92). When stratified by comorbid medical condition, among those with cardiovascular disease (OR, 0.63; 95% CI, 0.42-0.97), lipid metabolism disorders (OR, 0.63; 95% CI, 0.41-0.99), and the absence of cerebrovascular disease (OR, 0.76; 95% CI, 0.58-0.99), statins demonstrated a protective effect on open-angle glaucoma. Finally, a protective association was also observed among those who used nonstatin cholesterol-lowering agents (OR, 0.59; 95% CI, 0.37-0.97). Initial examination of an administrative clinical database indicates the intriguing possibility that long-term use of oral statins may be associated with a reduced risk of open-angle glaucoma, particularly among those with cardiovascular and lipid diseases. Nonstatin cholesterol-lowering agents were also associated with a reduced risk of having open-angle glaucoma. Additional investigation is warranted as to whether these classes of agents may provide an additional therapeutic addition for glaucoma.