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Statin treatment and reduced risk of pneumonia in patients with diabetes

¹ Utrecht Institute for Pharmaceutical Sciences (UIPS), Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht, The Netherlands
² St Antonius Hospital, Department of Clinical Pharmacy, Nieuwegein, The Netherlands
³ University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
⁴ St Antonius Hospital, Department of Pulmonary Diseases, Nieuwegein, The Netherlands

Correspondence to:
Correspondence to:
E M W van de Garde
Utrecht Institute for Pharmaceutical Sciences (UIPS), Department of Pharmacoepidemiology and Pharmacotherapy, Sorbonnelaan 16, 3583 CA Utrecht, The Netherlands; e.m.w.vandegarde{at}pharm.uu.nl

Background: Recent prognostic studies have shown that previous treatment with statins is associated with a better outcome in patients admitted to hospital with pneumonia. Because of an increased risk of pneumonia in patients with diabetes, we assessed the effects of statin use on the occurrence of pneumonia in adult diabetic patients.

Methods: All patients with a diagnosis of diabetes (types 1 and 2) enlisted in the UK General Practice Research Database between 1 June 1987 and 21 January 2001 were included. A case-control study was performed with cases defined as patients with a first recorded diagnosis of pneumonia. For each case up to four controls were matched by age, sex, practice, and index date. Patients were classified as current users when the index date was between the start and end date of statin treatment. Conditional multiple logistic regression analysis was used to estimate the strength of the association between statin treatment and the occurrence of pneumonia.

Results: Statins were used in 1.1% of 4719 cases and in 2.1% of 15 322 matched controls (crude odds ratio (OR) 0.51, 95% CI 0.37 to 0.68). After adjusting for potential confounders, treatment with statins was associated with a significant reduction in the risk of pneumonia (adjusted OR 0.49, 95% CI 0.35 to 0.69). The association was consistent among relevant subgroups (cardiovascular diseases, pulmonary diseases) and independent of the use of other prescription drugs.

Conclusions: The use of statins is associated with a considerable reduction in the risk of pneumonia in diabetic patients. In addition to lowering the risk of cardiovascular disease, statins may be useful in preventing respiratory infections.

Keywords: statins; pneumonia; prevention; epidemiology

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