Statin use and risk of epilepsy: a nested case-control study.
OBJECTIVE
To examine the potential efficacy of hydroxymethyl-glutaryl-coenzyme A reductase inhibitors (statins) in the prevention of epilepsy.


METHODS
This study was a population-based, nested case-control study among older adults in the province of Quebec, Canada. The primary cohort consisted of cardiovascular patients who had received a revascularization procedure. Within the cohort, those with the primary hospital diagnosis of epilepsy were identified (cases). Each case was matched to 10 controls by age and cohort entry time. Potential confounders were adjusted using a conditional logistic regression model. A sensitivity analysis was performed using propensity score matching.


RESULTS
The initial cohort consisted of 150,555 subjects. Within the cohort, 217 hospital-diagnosed cases of epilepsy and 2,170 corresponding controls were identified. The adjusted rate ratio (ARR) for epilepsy among current statin users was 0.65 (95% confidence interval [CI] 0.46-0.92). The ARR for past users of statins was 0.72 (95% CI 0.39-1.30). No benefit was found for the control drug groups, including nonstatin cholesterol-lowering drugs, β-blockers, and angiotensin-converting enzyme inhibitors (1.00 [95% CI 0.45-2.20], 1.04 [95% CI 0.74-1.47], and 0.94 [95% CI 0.66-1.33]).


CONCLUSIONS
These results suggest that statin use decreases the risk of hospitalization for epilepsy. Because of its observational nature, this study requires future research to confirm these intriguing findings.
Etminan
Mahyar
M
Center for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Canada. mahyar.etminan@vch.ca
Samii
Ali
A
Brophy
James M
JM
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D016022:Case-Control Studies; D015331:Cohort Studies; D018672:Community Health Planning; D016001:Confidence Intervals; D004827:Epilepsy / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D038801:International Classification of Diseases; D008297:Male; D057216:Propensity Score; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors