title: Association between statin use and uveitis: results from the Pacific Ocular Inflammation study.
abstract: OBJECTIVE
  To assess whether there is a protective association between statin use and uveitis diagnosis.
  
  
  METHODS
  Retrospective, population-based case-control study.
  
  
  METHODS
  Medical records of all patients in the Kaiser Permanente Hawaii health plan between January 1, 2006 and December 31, 2007 (N = 217 061) were searched electronically for International Classification of Diseases, 9th Revision, diagnosis codes related to uveitis. Chart review was done to confirm incident uveitis diagnosis during the study period. Two control groups were each randomly selected at a 5:1 ratio to cases, and controls were assigned an index date to match their respective case diagnosis date. One control group was selected from the general Kaiser Permanente Hawaii population that had at least 1 healthcare visit during the study period. Another control group was selected from the population of Kaiser Permanente Hawaii members who had at least 1 visit to the ophthalmology clinic during the study period. Statin use was defined as filling a prescription for statin medication in the year prior to the diagnosis or index date based on an electronic search of the Kaiser Permanente Hawaii pharmacy database for Generic Product Identification codes. A conditional logistic regression model with clinical diagnosis of uveitis as the outcome was used to assess the relationship between statin use and uveitis.
  
  
  RESULTS
  One hundred eight incident cases of uveitis were identified. Nineteen percent of uveitis patients had used statin medication in the year prior to diagnosis compared to 30% of patients in the general Kaiser population control (P = .03) and 38% of patients in the ophthalmology clinic control (P < .001). Using the general Kaiser population control and adjusting for age, sex, race, and autoimmune diseases, the odds of a statin user developing uveitis were 48% less than the odds of a non-statin user developing uveitis (OR: 0.52, 95% CI: 0.29-0.94, P = .03). Similarly, the odds of developing uveitis were 33% less for statin users compared to non-statin users (OR: 0.67, 95% CI: 0.38-1.19, P = .17) when adjusting for these factors and using the ophthalmology clinic control group.
  
  
  CONCLUSIONS
  Statin use may be protective against the development of uveitis. Several anti-inflammatory and immunomodulatory mechanisms may explain this association.
authors.affiliation: F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California.
authors.forename: Durga S
authors.initials: DS
authors.lastname: Borkar
authors.affiliation: Department of Ophthalmology, Kaiser Permanente Hawaii, Honolulu, Hawaii; Pacific Vision Institute of Hawaii, Honolulu, Hawaii.
authors.forename: Vivien M
authors.initials: VM
authors.lastname: Tham
authors.affiliation: F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Shen
authors.affiliation: Center for Health Research, Kaiser Permanente Hawaii, Honolulu, Hawaii.
authors.forename: John V
authors.initials: JV
authors.lastname: Parker
authors.affiliation: Center for Health Research, Kaiser Permanente Hawaii, Honolulu, Hawaii.
authors.forename: Aileen
authors.initials: A
authors.lastname: Uchida
authors.affiliation: Center for Health Research, Kaiser Permanente Hawaii, Honolulu, Hawaii.
authors.forename: Aleli C
authors.initials: AC
authors.lastname: Vinoya
authors.affiliation: F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, San Francisco, California. Electronic address: nisha.acharya@ucsf.edu.
authors.forename: Nisha R
authors.initials: NR
authors.lastname: Acharya
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D016208:Databases, Factual; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000188:drug therapy; D038801:International Classification of Diseases; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D012189:Retrospective Studies; D014605:Uveitis / Q000453:epidemiology* / Q000517:prevention & control*
chemical_list: D000924:Anticholesteremic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors