The Potential Protective Effects of Statins in Chronic Rhinosinusitis: A Case–Control Study

Abstract

Objectives/Hypothesis To determine the potential protective effect of prior statin use on the subsequent diagnosis of chronic rhinosinusitis (CRS). Study Design Retrospective, case‐control. Methods Electronic medical records for all patients seen in the otolaryngology clinic in 2019 and receiving a diagnosis of CRS were reviewed for the presence or absence of active prior statin use within 365 days of the visit. Similarly, prior statin use in a control group of patients without any diagnosis of CRS was also determined. Statin exposure in CRS patients was compared to statin exposure in control patients with 1:2 matching on age and sex with chi‐square and odds ratios were computed. Results In 2019, 3655 patients (mean age, 52.9 years, 56.4% female) were identified with a diagnosis of chronic rhinosinusitis versus 41,636 patients without any diagnosis of CRS. All chronic rhinosinusitis patients were successfully matched to 7310 controls. 6.3% of CRS patients (229 patients) had prior statin use, versus 8.5% (624 patients) of control patients. The average mean duration of statin use prior to visit was not significantly different between CRS and control patients (mean days, 202.3 days versus 205.6 days, respectively; P = .697). The presence of a statin medication in use was associated with a significant protective effect against a subsequent diagnosis of CRS with and odds ratio for CRS diagnosis of 0.716 (95% confidence interval, 0.612–0.838) in those patients taking a statin medication (P < .001). Conclusions The use of a statin medication was associated with a significant reduction in subsequent diagnosis of chronic rhinosinusitis. Level of Evidence 3 Laryngoscope, 131:E1431–E1433, 2021

Association of statins with quality of life and olfaction in patients with chronic rhinosinusitis

“…Findings of reduced symp-tom severity among statin users may help to explain, in part, results of population-based studies that reported the protective effects of statin use against a diagnosis of CRS. 2,3 Statin users had a higher prevalence of normosmia and, on average, higher individual T, D, and I scores; however, differences with non-statin users were not statistically significant in comparison. The lack of significance may be partially due to the relatively limited sample size of statin users.…”

“…Statins block the mevalonate pathway and prevent activation G proteins—a mechanism that may have a role in the management of airway inflammation 1 . Accordingly, multiple population‐based studies suggest that statins may be protective against development of CRS, whereas others have noted a potential detrimental effect, with concerns that statins may propogate some atopic diseases 2–4 . In vitro studies of human airway epithelial cells have demonstrated that expression of the inflammatory mediators C‐C motif chemokine ligand‐5 (CCL‐5), CCL‐11, interleukin‐5 (IL‐5), and IL‐13RA are inhibited by statin exposure 1 .…”

“…Additional investigation with increased sample size may help strengthen this statistical association and expand clinical interpretation. Findings of reduced symptom severity among statin users may help to explain, in part, results of population‐based studies that reported the protective effects of statin use against a diagnosis of CRS 2,3 …”

“…1 Accordingly, multiple population-based studies suggest that statins may be protective against development of CRS, whereas others have noted a potential detrimental effect, with concerns that statins may propogate some atopic diseases. [2][3][4] In vitro studies of human airway epithelial cells have demonstrated that expression of the inflammatory mediators C-C motif chemokine ligand-5 (CCL-5), CCL-11, interleukin-5 (IL-5), and IL-13RA are inhibited by statin exposure. 1 Furthermore, statins have been shown to enhance regeneration of olfactory neuroepithelium in murine models.…”

Is there an association between chronic rhinosinusitis and statins? A single institution study

“…6 Gilani et al performed a similar study in a single institution and found similar results. 5 Rimmer et al investigated the difference in subjective (SNOT-22 scores) and objective measures (LK, LM CT, and olfactory function) between CRS patients on statins and those not on statins. They found a significant difference in the total SNOT-22 score, as well as the rhinologic, ear/face, and psychological subdomains (all lower in statin users) of the SNOT-22 on univariable analysis.…”