Association of Statin Therapy With Risk of Epilepsy in 2 Propensity Score-Matched Cohorts

Ann Pharmacother. 2018 Jun;52(6):546-553. doi: 10.1177/1060028018756650. Epub 2018 Feb 3.

Abstract

Background: Studies have suggested that statins may have a neuroprotective effect against epilepsy. However, evidence from rat models and case reports have suggested an opposite effect. Overall data are limited.

Objective: To examine the association between statin use and epilepsy risk in a general population and in a healthy population (individuals with no severe comorbidities).

Methods: Patients were Tricare beneficiaries from October 2003 to March 2012. Based on patients' characteristics during baseline phase (fiscal year [FY] 2004-2005), 2 propensity score (PS)-matched cohorts of statin users and nonusers were formed: (1) a PS-matched general cohort and (2) a PS-matched healthy cohort. Our outcome was defined using inpatient or outpatient ICD-9 codes for epilepsy during the follow-up phase (FY 2006 to March 2012) in the cohorts of statin users and nonusers.

Results: The study included a total of 43 438 patients (13 626 statin users and 29 812 nonusers). The PS-matched general cohort matched 6342 statin users to 6342 nonusers; the odds ratio (OR) of epilepsy in this cohort during follow-up was 0.91; 95% CI = 0.67-1.23. The PS-matched healthy cohort matched 3351 statin users to 3351 nonusers; OR in the PS-matched healthy cohort during follow-up was 1.08; 95% CI = 0.64-1.83.

Conclusions: This study did not demonstrate a significant beneficial or deleterious effect of statin use on risk of being diagnosed with epilepsy. Clinicians should not withhold statins, whenever indicated, in patients with epilepsy.

Keywords: epilepsy; neuroprotection; statins.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Comorbidity
  • Epilepsy / epidemiology*
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Male
  • Middle Aged
  • Odds Ratio
  • Propensity Score
  • Risk

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors