Objectives
Animal studies and clinical trials have examined the potential benefits of statins in asthma management with contradictory results. The objective of this study was to determine if asthma patients on concurrent statins are less likely to have asthma-related hospitalisations.
Design
A retrospective cohort study using Mississippi Medicaid data for 2002–2004.
Participants
Asthma patients ≥18 years were identified using the ICD9 code 493.xx from 1 July 2002 through 31 December 2003. The index date for an exposed subject was any date within the identification period, 180 days prior to which the subject had at least one inhaled corticosteroid prescription and at least an 80% adherence rate to statins. Asthma patients on inhaled corticosteroids, but not on statins, were selected as the unexposed population. The two groups were matched and followed for 1 year beginning the index date.
Main outcomes measures
Patient outcomes in terms of hospitalisations and ER visits were compared using conditional logistic regression.
Results
After matching, there were 479 exposed subjects and 958 corresponding unexposed subjects. The odds of asthma-related hospitalisation and/or emergency room (ER) visits for asthma patients on concurrent statins were almost half the odds for patients not on statins (OR=0.55; 95% CI (0.37 to 0.84); p=0.0059). Similarly, the odds of asthma-related ER visits were significantly lower for patients on statins (OR=0.48; 95% CI (0.28 to 0.82); p=0.0069).
Conclusion
The findings suggest beneficial effects of statins in asthma management. Further prospective investigations are required to provide more conclusive evidence.
Article summary
Article focus
Statins have been shown to have promising therapeutic potential in mediating anti-inflammatory processes in animal model studies as well as clinical trials of rheumatoid arthritis, autoimmune encephalomyelitis, inflammatory colitis and psoriasis.
Along the same line of reasoning, recently there has been some discussion regarding the use of statins in asthma management in addition to inhaled corticosteroid therapy.
The purpose of this study was to investigate the beneficial effects of statins on asthma outcomes using the Mississippi Medicaid claims database.
Key messages
The findings suggest that statins may be beneficial in asthma management.
The study accounts for several additional potential confounders not previously explored in the other observational studies.
Strengths and limitations of this study
The study uses a propensity score-matched cohort study design, which in itself should take into account potential confounding effects.
The study was conducted using Medicaid claims data, and therefore, there is a possibility of misclassification due to coding errors during claims processing.