Statin Use Is Associated With a Lower Risk of TB

Su, Vin‐Cent; Su, Wei; Yen, Yung‐Feng; Pan, Shiann; Chuang, Pei Hung; Feng, Jia; Chou, Kun-Ta; Yang, Kuang Yao; Lee, Yu Chin; Chen, Tzeng Ji

doi:10.1016/j.chest.2017.04.170

Cited by 71 publications

(84 citation statements)

References 27 publications

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“…Recently, Su et al . reported that statin treatment is associated with a decreased risk of active TB . Although metformin users in the T2DM cohort had slightly higher rates of statin use in this study, metformin was still associated with a decreased risk of active TB after adjustment for statin use (Table ).…”

Section: Discussionmentioning

confidence: 99%

“…A recent analysis using a cross‐matched TB notification database and a NHI reimbursement database found that over 96% of TB patients were registered in the TB registry . We defined active TB as at least one outpatient visit or one hospital admission with ICD‐9‐CM codes for TB (010–018) during the follow‐up period and the prescription of more than two anti‐TB medications for more than 90 days during the study period …”

Section: Methodsmentioning

confidence: 99%

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Metformin is associated with a lower risk of active tuberculosis in patients with type 2 diabetes

Lin

et al. 2018

Respirology

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Metformin is associated with a lower risk of active tuberculosis in patients with type 2 diabetes

Lin

et al. 2018

Respirology

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“…For TB prevention by immunomodulation, statins are candidate drugs because they have demonstrated a host‐direct anti‐TB effect and are widely used for all patients with diabetes at sufficient risk of vascular events . Ensuing studies have discovered that statin‐users had a decreased risk of incident TB in the general population, although the nondrug comparator design may weaken the robustness of the results . Unusually, one cohort study in patients with diabetes reported no TB‐risk difference between statin‐users and nonusers .…”

Section: Discussionmentioning

confidence: 99%

“…The data source was the Longitudinal Health Insurance Database (LHID), which contains the comprehensive healthcare data of 1 000 000 representative samples from all the beneficiaries of the National Health Insurance program in Taiwan. The LHID is one subset of the National Health Insurance Research Database (NHIRD), and the accuracy of the major diagnosis codes in the NHIRD has been assessed previously . The Institutional Review Board of Taipei Veterans General Hospital approved this study employing de‐identified secondary data (2015–04‐004 AC).…”

Section: Methodsmentioning

confidence: 99%

“…The primary outcome was incident TB, which was defined as the presence of ICD‐9 codes 010–018 in ≥1 inpatient or ≥2 outpatient records along with the prescription of ≥2 anti‐TB drugs for ≥28 days within a 180‐day interval, as previously validated . The secondary outcomes was incident herpes zoster (codes 053.0–053.9), considered as an adverse effect of statins, which should occur before the primary endpoints including TB, along with diagnosis in ≥1 inpatient or ≥ 2 outpatient records.…”

Section: Methodsmentioning

confidence: 99%

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Opposite effects of statins on the risk of tuberculosis and herpes zoster in patients with diabetes: A population‐based cohort study

Pan

Yen

Feng

et al. 2020

Brit J Clinical Pharma

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Aims It remains uncertain whether statin use is associated with the risks of tuberculosis (TB) and herpes zoster in patients with type 2 diabetes. This study aims to assess the effects of statins vs nonstatin lipid‐lowering agents on the risk of these infectious diseases in patients with diabetes. Methods Participants in the Taiwan National Health Insurance Research Database diagnosed with type 2 diabetes in 2001–2013 were classified as statin users, nonstatin users and lipid‐lowering drug‐free groups. Participants were observed for incident TB and herpes zoster from diabetes diagnosis until treatment crossover or December 2013. Statin user and nonstatin user were the time‐dependent variables in Cox regression analysis. Results Over 240 782 person‐years of observation, statin users (n = 17 696) were associated with a lower TB risk than nonstatin users (n = 5327) and the drug‐free group (n = 22 316) (adjusted hazard ratio [aHR]: 0.66; 95% confidence interval [CI]: 0.44–0.99 and aHR: 0.57; 95% CI: 0.44–0.73). Compared with nonstatin users, statin users showed a dose‐dependent association with TB risk (low‐potency statin users, aHR: 0.692; 95% CI: 0.455–1.053; high‐potency users, aHR: 0.491; 95% CI: 0.241–0.999). Statin users presented with a higher risk of herpes zoster than nonstatin users and the drug‐free group (aHR: 1.23; 95% CI: 1.01–1.50 and aHR: 1.20; 95% CI: 1.09–1.33). The risks of TB and herpes zoster were not statistically different between nonstatin users and the drug‐free group. Conclusion Compared with nonstatin drugs, statin use was specifically associated with a decreased risk of TB but a moderately increased risk of herpes zoster in this cohort study.

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Effects of host‐directed therapies on the pathology of tuberculosis

Tsenova

Singhal

2020

The Journal of Pathology

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Mycobacterium tuberculosis, the causative agent of tuberculosis (TB), has co-evolved with the human immune system and utilizes multiple strategies to persist within infected cells, to hijack several immune mechanisms, and to cause severe pathology and tissue damage in the host. This delays the efficacy of current antibiotic therapy and contributes to the evolution of multi-drug-resistant strains. These challenges led to the development of the novel approach in TB treatment that involves therapeutic targeting of host immune response to control disease pathogenesis and pathogen growth, namely, host-directed therapies (HDTs). Such HDT approaches can (1) enhance the effect of antibiotics, (2) shorten treatment duration for any clinical form of TB, (3) promote development of immunological memory that could protect against relapse, and (4) ameliorate the immunopathology including matrix destruction and fibrosis associated with TB. In this review we discuss TB-HDT candidates shown to be of clinical relevance that thus could be developed to reduce pathology, tissue damage, and subsequent impairment of pulmonary function.

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Statin Use Is Associated With a Lower Risk of TB

Cited by 71 publications

References 27 publications

Metformin is associated with a lower risk of active tuberculosis in patients with type 2 diabetes

Metformin is associated with a lower risk of active tuberculosis in patients with type 2 diabetes

Opposite effects of statins on the risk of tuberculosis and herpes zoster in patients with diabetes: A population‐based cohort study

Effects of host‐directed therapies on the pathology of tuberculosis

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