Long-Term Statin Use May Decrease MPN Risk

Statin use may reduce the risk of developing a myeloproliferative neoplasm (MPN), according to a recent study.

Daniel Kristensen, MD, of Aalborg University and the Aalborg University Hospital in Denmark, and colleagues conducted the study and presented its results at the 2022 American Society of Hematology Annual Meeting and Exposition.

They conducted a population-based nested case-control study comparing statin use among patients diagnosed with MPN between 2010 and 2018 (n=3,816) and a matched population of people who did not have MPN (n=19,080) to assess the association between MPN and statin use. They identified cases of MPN through the Danish National Chronic Myeloid Neoplasia Registry, which covers at least 90% of the MPN cases in Denmark.

The researchers assessed statin exposure by using the Danish National Prescription Registry. They defined patients with “ever use” of statins as those who redeemed at least one statin prescription before their MPN diagnosis date, while they defined “never use” as occurring in those who did not fill a statin prescription prior to their diagnosis. Dr. Kristensen and colleagues defined “long-term use” as five years or more of statin treatment.

More than one-third (34.9%) of patients with MPN were categorized as “ever users,” while 33.5% of people without MPN were categorized as “ever users” (odds ratio [OR], 1.07; 95% CI, 0.99-1.16), with a fully adjusted OR of 0.87 for MPN. Nearly one-fifth (17.2%) of patients with MPN were long-term users of statins, while 19% of those without MPN were long-term users (OR, 0.90; 95% CI, 0.81-1.00), with a fully adjusted OR of 0.72 for MPN.

There was a “clear dose-dependent response” when the researchers analyzed cumulative time of exposure to statins, as adjusted ORs decreased with longer treatment durations. With an exposure of less than one year, the fully adjusted OR was 1.15, while it was 0.96 for an exposure of one to 4.99 years, 0.83 for an exposure of five to 9.999 years, and 0.63 for an exposure of 10 years or more.

A subgroup analysis showed being male was associated with decreased risk for developing MPN after long-term statin use with a fully adjusted OR of 0.57. Long-term statin use was also associated with decreased risk of myelofibrosis (MF), with a fully adjusted OR of 0.60; polycythemia vera (PV), with a fully adjusted OR of 0.73; and MPN unclassifiable, with a fully adjusted OR of 0.52. Long-term statin use had a neutral association with essential thrombocythemia [ET], with a fully adjusted OR of 0.89.

“To the best of our knowledge, this is the first study to examine the association between [statin] use and risk of MPNs. A protective effect of [statins] on the risk of developing MPN with a [fully adjusted] OR of 0.87 (0.80-0.96) was demonstrated, primarily driven by long-term use and a strong interaction by gender, where the association was particularly strong in males,” Kristensen and colleagues concluded. “Subgroup analyses revealed a protective effect for PV, MF, and MPN [unclassifiable], however not for ET. Further preclinical and clinical studies on this subject is warranted.”

Reference

Kristensen D, Oevlisen AK, Jakobsen LH, et al. Statin Use and the Risk of Myeloproliferative Neoplasms in a Population Based Cohort. Abstract #3032. Presented at the 64th ASH Annual Meeting and Exposition; December 10-13, 2022; New Orleans, Louisiana.