SNFGE SNFGE
 
Thématique :
- MICI
- Cancer colorectal (CCR)
Originalité :
Intermédiaire
Solidité :
Intermédiaire
Doit faire évoluer notre pratique :
Dans certains cas
 
 
Nom du veilleur :
Docteur Stéphane NAHON
Coup de coeur :
 
 
Clinical Gastroenterology and Hepatology
  2016/07  
 
  2016 Jul;14(7):973-9  
  Doi: 10.1016/j.cgh.2016.02.017  
 
  Statin Use Is Associated With Reduced Risk of Colorectal Cancer in Patients With Inflammatory Bowel Diseases  
 
  Ananthakrishnan AN, Cagan A, Cai T, Gainer VS, Shaw SY, Churchill S, Karlson EW, Murphy SN, Liao KP, Kohane I  
  http://www.cghjournal.org/article/S1542-3565(16)00165-8/abstract  
 
 

BACKGROUND & AIMS:

Inflammatory bowel diseases (IBDs) such as Crohn's disease and ulcerative colitis are associated with an increased risk of colorectal cancer (CRC). Chemopreventive strategies have produced weak or inconsistent results. Statins have been associated inversely with sporadic CRC. We examined their role as chemopreventive agents in patients with IBD.

METHODS:

We collected data from 11,001 patients with IBD receiving care at hospitals in the Greater Boston metropolitan area from 1998 through 2010. Diagnoses of CRC were determined using validated International Classification of Diseases, 9th revision, Clinical Modification codes. Statin use before diagnosis was assessed through analysis of electronic prescriptions. We performed multivariate logistic regression analyses, adjusting for potential confounders including primary sclerosing cholangitis, smoking, increased levels of inflammation markers, and CRC screening practices to identify an independent association between statin use and CRC. We performed sensitivity analyses using propensity score adjustment and variation in the definition of statin use.

RESULTS:

In our cohort, 1376 of the patients (12.5%) received 1 or more prescriptions for a statin. Patients using statins were more likely to be older, male, white, smokers, and have greater comorbidity than nonusers. Over a follow-up period of 9 years, 2% of statin users developed CRC compared with 3% of nonusers (age-adjusted odds ratio, 0.35; 95% confidence interval, 0.24-0.53). On multivariate analysis, statin use remained independently and inversely associated with CRC (odds ratio, 0.42; 95% confidence interval, 0.28-0.62). Our findings were robust on a variety of sensitivity and subgroup analyses.

CONCLUSIONS:

Statin use was associated inversely with the risk of CRC in a large IBD cohort. Prospective studies on the role of statins as chemopreventive agents are warranted.

 
Question posée
 
L’utilisation de statines est-elle associée à une diminution du risque de cancer colorectal chez les patients atteints de MICI ?
 
Question posée
 
En analyse uni et multivariée, la prise de statines était associée à une diminution du risque de CCR chez les patients ayant une MICI.
 
Commentaires

Dans cette cohorte de 11000 patients, 12,6% des patients prenaient une statine ; il s’agissait de patients plus âgés, fumeurs, ayant plus de comorbidités. Ce signal intéressant mérite d’être confirmé par des études prospectives.

 
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