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Statins Decrease the Risk of Orbitopathy in Newly Diagnosed Patients with Graves Disease

Nilsson, Anton LU ; Tsoumani, Kleoniki and Planck, Tereza LU (2021) In The Journal of clinical endocrinology and metabolism 106(5). p.1325-1332
Abstract

CONTEXT/OBJECTIVE: The aim of this study was to examine the effect of statins and other lipid-lowering agents on the development of Graves orbitopathy (GO) in patients with newly diagnosed Graves disease (GD). METHODS: Our sample included the full adult population of individuals living in Sweden with newly diagnosed GD between 2005 and 2018 (n = 34 894). We compared the GO incidence in statin users (n = 5574) and nonusers (n = 34 409) by applying Cox regression with a time-varying exposure variable. We adjusted for age, sex, and treatment for hyperthyroidism in the multivariate analyses. RESULTS: Periods of nonusage lasted for a median of 4.3 years (interquartile range [IQR] 1.2-8.4), whereas periods of usage lasted for a median of 4.7... (More)

CONTEXT/OBJECTIVE: The aim of this study was to examine the effect of statins and other lipid-lowering agents on the development of Graves orbitopathy (GO) in patients with newly diagnosed Graves disease (GD). METHODS: Our sample included the full adult population of individuals living in Sweden with newly diagnosed GD between 2005 and 2018 (n = 34 894). We compared the GO incidence in statin users (n = 5574) and nonusers (n = 34 409) by applying Cox regression with a time-varying exposure variable. We adjusted for age, sex, and treatment for hyperthyroidism in the multivariate analyses. RESULTS: Periods of nonusage lasted for a median of 4.3 years (interquartile range [IQR] 1.2-8.4), whereas periods of usage lasted for a median of 4.7 years (IQR 2.0-8.1). Among statin users, 77.1% had used simvastatin, 28.9% atorvastatin, and 8.2% had used other statins. Statin users were found to be significantly less likely to develop GO. In the main analysis based on the full cohort, the unadjusted hazard ratio (HR) was 0.74 (CI 0.65-0.84, P < .001), whereas full adjustment altered the effect to 0.87 (CI 0.76-1.00, P = .04). The main results were largely driven by men; the fully adjusted HR was 0.78 (CI 0.58-1.04, P = .09) for men and 0.91 (CI 0.79-1.06, P = .24) for women. Lipid-lowering agents other than statins did not exhibit a similar protective effect. CONCLUSION: In newly diagnosed patients with GD, treatment with statins may protect against the development of GO. Statins should be investigated in a clinical trial as a preventive treatment for GO in newly diagnosed patients with GD.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
3-hydroxy-3-methylglutaryl-coenzyme reductase inhibitors, Graves disease, Graves orbitopathy, statins
in
The Journal of clinical endocrinology and metabolism
volume
106
issue
5
pages
8 pages
publisher
Oxford University Press
external identifiers
  • pmid:33560351
  • scopus:85105761037
ISSN
1945-7197
DOI
10.1210/clinem/dgab070
language
English
LU publication?
yes
id
21ec5e64-9d5b-494a-b335-eb2119994cb0
date added to LUP
2021-06-01 00:04:25
date last changed
2024-06-15 11:49:10
@article{21ec5e64-9d5b-494a-b335-eb2119994cb0,
  abstract     = {{<p>CONTEXT/OBJECTIVE: The aim of this study was to examine the effect of statins and other lipid-lowering agents on the development of Graves orbitopathy (GO) in patients with newly diagnosed Graves disease (GD). METHODS: Our sample included the full adult population of individuals living in Sweden with newly diagnosed GD between 2005 and 2018 (n = 34 894). We compared the GO incidence in statin users (n = 5574) and nonusers (n = 34 409) by applying Cox regression with a time-varying exposure variable. We adjusted for age, sex, and treatment for hyperthyroidism in the multivariate analyses. RESULTS: Periods of nonusage lasted for a median of 4.3 years (interquartile range [IQR] 1.2-8.4), whereas periods of usage lasted for a median of 4.7 years (IQR 2.0-8.1). Among statin users, 77.1% had used simvastatin, 28.9% atorvastatin, and 8.2% had used other statins. Statin users were found to be significantly less likely to develop GO. In the main analysis based on the full cohort, the unadjusted hazard ratio (HR) was 0.74 (CI 0.65-0.84, P &lt; .001), whereas full adjustment altered the effect to 0.87 (CI 0.76-1.00, P = .04). The main results were largely driven by men; the fully adjusted HR was 0.78 (CI 0.58-1.04, P = .09) for men and 0.91 (CI 0.79-1.06, P = .24) for women. Lipid-lowering agents other than statins did not exhibit a similar protective effect. CONCLUSION: In newly diagnosed patients with GD, treatment with statins may protect against the development of GO. Statins should be investigated in a clinical trial as a preventive treatment for GO in newly diagnosed patients with GD.</p>}},
  author       = {{Nilsson, Anton and Tsoumani, Kleoniki and Planck, Tereza}},
  issn         = {{1945-7197}},
  keywords     = {{3-hydroxy-3-methylglutaryl-coenzyme reductase inhibitors; Graves disease; Graves orbitopathy; statins}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{5}},
  pages        = {{1325--1332}},
  publisher    = {{Oxford University Press}},
  series       = {{The Journal of clinical endocrinology and metabolism}},
  title        = {{Statins Decrease the Risk of Orbitopathy in Newly Diagnosed Patients with Graves Disease}},
  url          = {{http://dx.doi.org/10.1210/clinem/dgab070}},
  doi          = {{10.1210/clinem/dgab070}},
  volume       = {{106}},
  year         = {{2021}},
}