【medical-news】AAAAI 2009: 他汀类显著降低哮喘住院风险
发布于 2009-03-22 · 浏览 1350 · IP 安徽安徽
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AAAAI 2009: Statin Use Significantly Lowers Risk for Hospitalization for Asthma
March 17, 2009 (Washington, DC) — Adult patients with asthma who are receiving statin therapy for other comorbidities have a 33% lower risk for hospitalization or emergency-department visits than asthmatics not receiving lipid-lowering therapy, according to findings presented here at the 2009 American Academy of Asthma, Allergy and Immunology (AAAAI) Annual Meeting.
"These findings support the hypothesis that statins may improve clinical outcomes in adults with asthma and provide additional support for prospective investigation," said principal investigator Eric J. Stanek, PharmD, senior director of Research, Personalized Medicine, at Medco Health Solutions, Inc., in Franklin Lakes, New Jersey, during his presentation of his group's findings.
The findings come from a retrospective claims-based cohort study from the Medco Health Solutions national integrated database, which contains information on more than 12 million members.
Patients in the study were older than 18 years and had been given a prescription for an inhaled corticosteroid at some point during 2006. Patients had either made an emergency-department visit or had been hospitalized with asthma at least once during that year.
Patients not receiving statins were significantly younger than those who were (57±17 years vs. 67±11 years; P < .0001). Seventy-three percent of those not receiving statins were women, compared with 65% of those who were (P < .0001). The mean number of days exposed to statin therapy was 270.
Cardiovascular disease had been diagnosed in 5.5% of those not receiving statins, compared with 16.5% of those who were (P < .0001). Diabetes had been diagnosed in 8.9% of the group not receiving statins, compared with 19.5% of those who were (P < .0001).
At 12 months, the hospitalization incidence was 17% among the nonstatin users, compared with just under 15% for statin users, with an 18% lower incidence in favor of the statin group. Trips to the emergency department were approximately 15% among nonusers and 8% among users, a 44% reduction in incidence.
For hospitalizations and emergency-department visits combined, the incidence was nearly 30% without statins and 20% with statins, for an overall reduction in incidence of 30%.
The adjusted odds ratio for the primary end point with statin use was 0.67 (95% confidence interval, 0.58 – 0.76; P < .0001), Dr. Stanek announced.
"Inflammation is a hallmark of asthma," Dr. Stanek said. "The potential impact of statins may be large on a population basis for patients with asthma.
"Adherence to guideline-supported asthma care absolutely remains the therapeutic mainstay," Dr. Stanek asserted, but he pointed out that "data indicate that between 10% and 30% of adult asthma patients have cardiovascular or diabetes comorbidities that may require statin therapy."
Clifford W. Bassett, MD, from the Allergy and Asthma Care of New York, in New York City, and chair of public education for the AAAAI, agreed. "A 30% lower incidence of hospitalization with statin use is a huge number. There is some connection, but what that is specifically, we don't know. We don't know if an anti-inflammatory effect of the statins is reducing risk of hospitalization for asthma. It's too soon to say.
"It's important that we manage comorbidities," Dr. Bassett told Medscape Allergy & Clinical Immunology. "These are patients with diabetes and cardiovascular diseases. These chronic diseases appear to be intermingling . . . and while statins are not indicated for asthma, the results are very intriguing. We need to be looking for other diseases that may have an effect on asthma," he said.
"We need to strongly adhere to practice guidelines with statins . . . and with asthma," Dr. Bassett said, "and the word is getting out on the guidelines."
Dr. Stanek's study was funded by Medco Health Solutions, Inc. Dr. Bassett has disclosed no relevant financial relationships.
2009 American Academy of Asthma, Allergy and Immunology (AAAAI) Annual Meeting: Abstract 238. Presented March 14, 2009.
March 17, 2009 (Washington, DC) — Adult patients with asthma who are receiving statin therapy for other comorbidities have a 33% lower risk for hospitalization or emergency-department visits than asthmatics not receiving lipid-lowering therapy, according to findings presented here at the 2009 American Academy of Asthma, Allergy and Immunology (AAAAI) Annual Meeting.
"These findings support the hypothesis that statins may improve clinical outcomes in adults with asthma and provide additional support for prospective investigation," said principal investigator Eric J. Stanek, PharmD, senior director of Research, Personalized Medicine, at Medco Health Solutions, Inc., in Franklin Lakes, New Jersey, during his presentation of his group's findings.
The findings come from a retrospective claims-based cohort study from the Medco Health Solutions national integrated database, which contains information on more than 12 million members.
Patients in the study were older than 18 years and had been given a prescription for an inhaled corticosteroid at some point during 2006. Patients had either made an emergency-department visit or had been hospitalized with asthma at least once during that year.
Patients not receiving statins were significantly younger than those who were (57±17 years vs. 67±11 years; P < .0001). Seventy-three percent of those not receiving statins were women, compared with 65% of those who were (P < .0001). The mean number of days exposed to statin therapy was 270.
Cardiovascular disease had been diagnosed in 5.5% of those not receiving statins, compared with 16.5% of those who were (P < .0001). Diabetes had been diagnosed in 8.9% of the group not receiving statins, compared with 19.5% of those who were (P < .0001).
At 12 months, the hospitalization incidence was 17% among the nonstatin users, compared with just under 15% for statin users, with an 18% lower incidence in favor of the statin group. Trips to the emergency department were approximately 15% among nonusers and 8% among users, a 44% reduction in incidence.
For hospitalizations and emergency-department visits combined, the incidence was nearly 30% without statins and 20% with statins, for an overall reduction in incidence of 30%.
The adjusted odds ratio for the primary end point with statin use was 0.67 (95% confidence interval, 0.58 – 0.76; P < .0001), Dr. Stanek announced.
"Inflammation is a hallmark of asthma," Dr. Stanek said. "The potential impact of statins may be large on a population basis for patients with asthma.
"Adherence to guideline-supported asthma care absolutely remains the therapeutic mainstay," Dr. Stanek asserted, but he pointed out that "data indicate that between 10% and 30% of adult asthma patients have cardiovascular or diabetes comorbidities that may require statin therapy."
Clifford W. Bassett, MD, from the Allergy and Asthma Care of New York, in New York City, and chair of public education for the AAAAI, agreed. "A 30% lower incidence of hospitalization with statin use is a huge number. There is some connection, but what that is specifically, we don't know. We don't know if an anti-inflammatory effect of the statins is reducing risk of hospitalization for asthma. It's too soon to say.
"It's important that we manage comorbidities," Dr. Bassett told Medscape Allergy & Clinical Immunology. "These are patients with diabetes and cardiovascular diseases. These chronic diseases appear to be intermingling . . . and while statins are not indicated for asthma, the results are very intriguing. We need to be looking for other diseases that may have an effect on asthma," he said.
"We need to strongly adhere to practice guidelines with statins . . . and with asthma," Dr. Bassett said, "and the word is getting out on the guidelines."
Dr. Stanek's study was funded by Medco Health Solutions, Inc. Dr. Bassett has disclosed no relevant financial relationships.
2009 American Academy of Asthma, Allergy and Immunology (AAAAI) Annual Meeting: Abstract 238. Presented March 14, 2009.
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