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Abstract
Objective: To evaluate the effect of discontinuing statin therapy on incidence of Parkinson disease (PD) in statin users.
Methods: Participants who were free of PD and initiated statin therapy were recruited between 2001 and 2008. We examined the association between discontinuing use of statins with different lipophilicity and the incidence of PD using the Cox regression model with time-varying statin use.
Results: Among the 43,810 statin initiators, the incidence rate for PD was 1.68 and 3.52 per 1,000,000 person-days for lipophilic and hydrophilic statins, respectively. Continuation of lipophilic statins was associated with a decreased risk of PD (hazard ratio [HR] 0.42 [95% confidence interval 0.27–0.64]) as compared with statin discontinuation, which was not modified by comorbidities or medications. There was no association between hydrophilic statins and occurrence of PD. Among lipophilic statins, a significant association was observed for simvastatin (HR 0.23 [0.07–0.73]) and atorvastatin (HR 0.33 [0.17–0.65]), especially in female users (HR 0.11 [0.02–0.80] for simvastatin; HR 0.24 [0.09–0.64] for atorvastatin). As for atorvastatin users, the beneficial effect was seen in the elderly subgroup (HR 0.42 [0.21–0.87]). However, long-term use of statins, either lipophilic or hydrophilic, was not significantly associated with PD in a dose/duration-response relation.
Conclusions: Continuation of lipophilic statin therapy was associated with a decreased incidence of PD as compared to discontinuation in statin users, especially in subgroups of women and elderly. Long-term follow-up study is needed to clarify the potential beneficial role of lipophilic statins in PD.
GLOSSARY
- ATC=
- anatomical therapeutic chemical;
- CI=
- confidence interval;
- COPD=
- chronic obstructive lung disease;
- CoQ10=
- coenzyme Q10;
- HMG-CoA=
- 3-hydroxy-3-methylglutaryl coenzyme A;
- HR=
- hazard ratio;
- ICD-9-CM=
- International Classification of Diseases, ninth revision, clinical modification;
- LDL=
- low-density lipoprotein;
- NHI=
- National Health Insurance;
- NHIRD=
- National Health Insurance Research Database;
- NSAID=
- nonsteroidal anti-inflammatory drugs;
- PD=
- Parkinson disease
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
↵* These authors contributed equally to this work.
Editorial, page 406
Supplemental data at www.neurology.org
- Received December 16, 2012.
- Accepted in final form April 1, 2013.
- © 2013 American Academy of Neurology
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