Statin Use is Associated with a Lower Risk of Tuberculosis

Background

Statins are widely used to lower cholesterol levels and cardiovascular risk. Further, studies have shown that statins may decrease the risks of infectious diseases and infection-related mortality. However, the association between statin use and active tuberculosis (TB) disease remains unclear.

Methods

Using the Taiwan National Health Insurance Research Database, we conducted a nationwide population-based study. Patients taking statins during 2000–2013, without antecedent TB disease, were included. Data from 102,424 statin users and 202,718 age-, sex-, and enrollment date-matched subjects were analyzed. The two cohorts were monitored until December 31, 2013 for incident TB disease. The definition of TB disease was validated using the claims database of Taipei Veterans General Hospital.

Results

The statin and matched cohorts were observed for 571,568 and 1,027,385 person-years, respectively. Of the total 305,142 subjects, 1,264 (0.41%) developed subsequent TB disease. Validation study confirmed the accuracy of the definition of TB disease (sensitivity, 96.3%), with excellent interobserver agreement (κ=1.00). Multivariate analysis revealed a reduced risk of TB disease among the statin cohort (hazard ratio [HR] 0.53, 95% confidence interval [CI] 0.47-0.61; p365 cDDDs: HR 0.27, 95% CI 0.22-0.33, pConclusions

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