Statins May Decrease the Risk for Active Tuberculosis

This article is part of Infectious Disease Advisor‘s coverage of IDWeek 2018, taking place in San Francisco, CA. Our on-site staff will be reporting on the latest breaking research and clinical advances in infectious diseases. Check back regularly for highlights from IDWeek 2018.

SAN FRANCISCO — The use of statins may decrease the risk for active tuberculosis (TB), according to the results of a study presented on Tuberculosis and Other Mycobacterial Infections at IDWeek 2018, held October 3 to 7, 2018, in San Francisco, California.

Statins are lipid-lowering agents that are widely used to lower cholesterol levels and cardiovascular disease risk. Previous studies have shown that because of their anti-inflammatory and immunomodulatory properties, statins may decrease the risk for infectious diseases and infection-related mortality. More specifically, these properties may affect the development of TB. However, the association between statin use and active TB disease remains unclear. This study assessed the association between statins and the risk for active TB with propensity score matching.

The researchers used South Korea’s National Health Insurance database of approximately 1 million people and its subset database of the “medical check-up” population of approximately 570,000 people, which was representative of the entire population of the country, to establish their cohort sample for this study. After propensity score matching, 26,036 individuals who used statin medications and 26,036 individuals who did not use statins were monitored and analyzed for the development of active TB from 2003 to 2013.

Over the duration of the study, 150 active TB cases in 31,645 person-years (4.74 per 1000 person-years; 95% CI, 3.98-5.50) developed in individuals who used statins and 902 active TB cases in 153,401 person-years (5.88 per 1000 person-years, 95% CI, 5.50-6.26) developed in individuals who did not use statins. Individuals who used statins showed a significantly lower risk for TB than those who did not, with a hazard ration (HR), .78 (95% CI, .65-.93; P =.006). Further, a subgroup analysis demonstrated that statin use reduced the risk for TB significantly in individuals without diabetes (HR .73; 95% CI, .56-.95; P=.018), but not in individuals who have diabetes (HR .83; 95% CI, .54-1.28; P =.40).

Overall, the study authors concluded that, “These epidemiologic findings provide strong evidence that statin use decreases the risk of active TB.”

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Reference

Kim MC, Yun SC, Kim SH. Statins decrease the risk of active tuberculosis: a propensity score-matched analysis. Presented at: IDWeek 2018; October 3-7, 2018; San Francisco, CA. Poster 773.