The effect of statins on the occurrence of peptic ulcer

Feng, An‐Ning; Chuang, Eric Y.; Wu, Shang-Lin; Wang, Jia‐Chi; Chang, Shang‐Tzen; Lin, Cheng‐Li; Kao, Chia‐Hung

doi:10.1016/j.ejim.2015.07.015

Cited by 7 publications

(7 citation statements)

References 34 publications

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“…[18,19] At the same time, a case-control analysis performed on a Taiwanese population revealed a reduced incidence of peptic ulcer disease associated with chronic statin therapy. [5,17] Our study also suggests that statins have a protective role against ASA-induced lesions. Statins do not abate completely the gastrotoxic effect of aspirin intake, but we noticed an important reduction of the estimated risk for developing mild or severe endoscopic lesions, from 6.26 to 3.40 when statin therapy was associated.…”

Section: Discussionsupporting

confidence: 64%

“…[2–4] The protective effect of statins is due to their properties of atherosclerotic plaque stabilization and endothelial nitric oxide (NO) synthesis. [5–7] It is believed that by reducing cholesterol levels and strengthening endothelial function, statins may also have a pro-angiogenic effect. [5,8] Due to their additional antioxidant, anti-inflammatory, and immunomodulatory positive effects, statins have been proven to reduce the risk of fractures [9] and the incidence of dementia, [10] cataract, or cancer (colorectal, lung, prostate, and reproductive organs).…”

Section: Introductionmentioning

confidence: 99%

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Statins and gastroduodenal endoscopic lesions

Pantea

Negovan

Voidăzan³

et al. 2018

Medicine

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Experimental studies showed a dose-dependent gastroprotective effect of statins on non-steroidal anti-inflammatory drug-induced endoscopic lesions, modulated by increasing endogenous nitric oxide and prostaglandin production.We investigated the influence of chronic treatment with statins on the occurrence of endoscopic lesions in patients referred for endoscopic evaluation, adjusted for the most important etiologic and risk factors for peptic ulcer disease and its complications.A consecutive series of 564 patients who underwent upper digestive endoscopy, stratified according to the severity of endoscopic lesions were recruited. Patients with statin therapy were included in the study group (n = 220), while patients without statins in the control group (n = 344). We correlate the influence of chronic statin therapy (at least 6 months) with factors including age up to 50 years, Helicobacter pylori infection, smoking and drinking habits, ulcer history, gastrotoxic drug consumption (low-dose aspirin [ASA], anticoagulants), and comorbidities.H pylori infection was more frequent in patients with mild/severe endoscopic lesions vs. no lesions, in both groups, but the difference was not statistically significant (P >.05). Male gender represented a risk factor (P <.01) for mild/severe endoscopic lesions only in the statin group. The estimated risk for developing mild/severe endoscopic lesions with ASA intake decreased from 6.26 to 3.40 (P <.01) when statin therapy was associated. Patients without statins and ischemic coronary artery disease (P <.01; odds ratio [OR] = 2.99; 95% confidence interval (CI):1.88–4.73), heart failure (P = .01; OR = 2.13; 95% CI:1.36–3.34), systemic atherosclerosis (P = .04; OR = 2.30; 95% CI:1.44–3.67) had a statistically significant increased risk for developing mild/severe endoscopic lesions in comparison with patients in the statin group. In multivariate regression analysis models, smoking (P <.01; OR = 2.69; 95% CI:1.73–4.16), ASA (P <.01; OR = 4.54; 95% CI:2.83–7.16), and coronary artery diseases (P = .01; OR = 1.80; 95% CI:1.15–2.82) were independent risk factors for mild/severe endoscopic lesions, while chronic statin therapy (P <.01; OR = 0.31; 95% CI:0.19–0.51) was associated with a protective effect in all models.The results of the present study support a certain protective role of chronic therapy with statins against endoscopic lesions, especially in ASA consumers or patients with cardiovascular diseases.

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Section: Discussionsupporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Statins and gastroduodenal endoscopic lesions

Pantea

Negovan

Voidăzan³

et al. 2018

Medicine

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“…Although our previous study reported the protective effects of statins against peptic ulcer (Feng et al, 2015), several limitations and confounding factors exist. In the current study, we further analyzed the potential confounding medications including aspirin and NSAIDs.…”

Section: Discussionmentioning

confidence: 91%

Statin Therapy Is Associated with Reduced Risk of Peptic Ulcer Disease in the Taiwanese Population

et al. 2017

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Although statin use may affect the severity of chronic gastritis and gastric cancer, no data exists about the relationship between statin therapy and risk of peptic ulcer disease (PUD) in patients. We investigated the effect of statin use and the incidence of PUD from the Taiwan National Health Insurance Research Database (NHIRD). A total of 35,194 patients records for medical claims were enrolled. We performed a population-based case-control analysis to compare the incidence of PUD in patients who were prescribed statins and that in patients who were not. In the univariate logistic analysis, we found that statin was not significant risk of PUD. However, a multivariate model indicates that satin use was significantly associated with a reduced risk of PUD (adjusted odds ratio [aOR] = 0.87, 95% CI = 0.82–0.93, P < 0.001). The cumulative defined daily dose (DDD) was analyzed. Patients who prescribed fluvastatin ≥280 DDD, atorvastatin ≥200 DDD, and pravastatin ≥130 DDD dramatically decreased risk for PUD (aOR = 0.58, 0.67, and 0.71; 95% CI = 0.46–0.74, 0.57–0.78, and 0.56–0.91, respectively). Our results showed that statin therapy reduced the risk of PUD and this was associated with the high cumulative DDD of prescribed statins. This study reveals that active use of statins to be associated with decreased risk for PUD.

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“…In that study, PUD patients 60 years or older used, however, less commonly those drugs than the background control population. In a recently published population‐based cohort study from Taiwan, the use of statins was associated with a significant lower occurrence of PUD compared to non‐statin cohort population in all age groups …”

Section: Discussionmentioning

confidence: 97%

“…In a recently published population-based cohort study from Taiwan, the use of statins was associated with a significant lower occurrence of PUD compared to non-statin cohort population in all age groups. 33 A recent large meta-analysis, including 27 randomised trials with 174 000 patients on the efficacy and safety of LDL-lowering therapy in both genders, demonstrated a significant all-cause mortality reduction with statin therapy for both women (RR 0.91; 99% CI 0.84-0.99), and men (RR 0.90; 99% CI 0.86-0.95). 34 Among elderly people with no known history of vascular events, the use of statins or fibrates was associated with a 30% decrease in the incidence of stroke.…”

Section: Discussionmentioning

confidence: 99%