Statins and Lower Gastrointestinal Conditions: A Retrospective Cohort Study

Michelle Pearlman, Yvonne Covin, Robert Schmidt, Eric M. Mortensen, Ishak A. Mansi

Research output: Contribution to journalArticle

Abstract

Several studies have reported constipation, abdominal pain, or diarrhea as common adverse events for statins. Statins are among the most commonly prescribed medications, and the impact on the prevalence of these conditions was rarely studied as main outcomes. The aim of this study is to determine if statin therapy is associated with constipation, abdominal pain, diarrhea, or colitis. This was a retrospective cohort study using a regional military health care data from October 1, 2003, to March 1, 2012. A propensity score-matched cohort of statin users and nonusers was created based on 82 variables. The primary analysis evaluated the odds ratios of the following diagnoses: constipation, ≥3 encounters for constipation; abdominal pain, ≥3 encounters for abdominal pain; diarrhea, ≥3 encounters for diarrhea; colitis, ≥3 encounters for colitis; and endoscopy of the lower gastrointestinal tract, ≥3 endoscopies of the lower gastrointestinal tract. After propensity score matching of 6342 statin users and 6342 nonusers, there was no statistically significant difference in constipation (OR, 0.96; 95%CI, 0.87-1.05; P = .33), abdominal pain (OR, 0.95; 95%CI, 0.88-1.02; P = .15), or colitis (OR, 1.02; 95%CI, 0.91-1.14; P = .73). However, there was an association between statin therapy and endoscopy of the lower gastrointestinal tract (OR, 1.14; 95%CI, 1.04-1.26; P = .002) and decreased odds of diarrhea (OR, 0.88; 95%CI, 0.80-0.97; P = .01). In this retrospective cohort study, an association between statin therapy and increased likelihood of being diagnosed with lower gastrointestinal conditions could not be demonstrated, contrary to some statins package inserts.

Original languageEnglish (US)
JournalJournal of Clinical Pharmacology
DOIs
StateAccepted/In press - 2017

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cohort Studies
Retrospective Studies
Constipation
Abdominal Pain
Lower Gastrointestinal Tract
Diarrhea
Colitis
Endoscopy
Propensity Score
Product Labeling
Therapeutics
Odds Ratio
Delivery of Health Care

Keywords

  • Abdominal pain
  • Colonoscopy
  • Constipation
  • Diarrhea
  • Statins

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Statins and Lower Gastrointestinal Conditions : A Retrospective Cohort Study. / Pearlman, Michelle; Covin, Yvonne; Schmidt, Robert; Mortensen, Eric M.; Mansi, Ishak A.

In: Journal of Clinical Pharmacology, 2017.

Research output: Contribution to journalArticle

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abstract = "Several studies have reported constipation, abdominal pain, or diarrhea as common adverse events for statins. Statins are among the most commonly prescribed medications, and the impact on the prevalence of these conditions was rarely studied as main outcomes. The aim of this study is to determine if statin therapy is associated with constipation, abdominal pain, diarrhea, or colitis. This was a retrospective cohort study using a regional military health care data from October 1, 2003, to March 1, 2012. A propensity score-matched cohort of statin users and nonusers was created based on 82 variables. The primary analysis evaluated the odds ratios of the following diagnoses: constipation, ≥3 encounters for constipation; abdominal pain, ≥3 encounters for abdominal pain; diarrhea, ≥3 encounters for diarrhea; colitis, ≥3 encounters for colitis; and endoscopy of the lower gastrointestinal tract, ≥3 endoscopies of the lower gastrointestinal tract. After propensity score matching of 6342 statin users and 6342 nonusers, there was no statistically significant difference in constipation (OR, 0.96; 95{\%}CI, 0.87-1.05; P = .33), abdominal pain (OR, 0.95; 95{\%}CI, 0.88-1.02; P = .15), or colitis (OR, 1.02; 95{\%}CI, 0.91-1.14; P = .73). However, there was an association between statin therapy and endoscopy of the lower gastrointestinal tract (OR, 1.14; 95{\%}CI, 1.04-1.26; P = .002) and decreased odds of diarrhea (OR, 0.88; 95{\%}CI, 0.80-0.97; P = .01). In this retrospective cohort study, an association between statin therapy and increased likelihood of being diagnosed with lower gastrointestinal conditions could not be demonstrated, contrary to some statins package inserts.",
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