Solna [Sweden], September 3 : Statins that decrease cholesterol may protect individuals with ulcerative colitis from developing and dying from colon cancer. In individuals with ulcerative colitis or Crohn's disease, statin medication was also related to a decreased risk of death regardless of reason. This is according to research.
Study led by researchers at Karolinska Institutet in Sweden and findings were published in eClinicalMedicine.
“Even though more studies are needed to confirm our results, our study suggests that statins can prevent colorectal cancer in patients with inflammatory bowel disease (IBD), which is a high-risk group for this kind of cancer,” says the study’s first author Jiangwei Sun, researcher at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.
Dr. Sun and his colleagues conducted an observational study on over 10,500 IBD patients from across the country, half of whom were statin users; the other half, who were matched with the first, were not. After an average of 5.6 years of follow-up, 70 people in the statin group and 90 people in the non-statin group had colorectal cancer.
The protective effect was directly proportional to the length of time the patient had been on statins and could be demonstrated after two years’ treatment.
There were also fewer deaths from colorectal cancer in the statin group (20) than in the non-statin group (37) during the study period, and deaths regardless of cause (529 versus 719).
The study shows that some 200 IBD patients need to be treated with statins to avoid one case of colorectal cancer or death from the cancer within ten years of treatment onset. The protective effect was only statistically valid for patients with ulcerative colitis.
“We think this is because the study contained fewer patients with Crohn’s disease,” explains Dr Sun. “More and larger studies compiling data from patient populations in many countries will probably be needed to achieve statistical significance for Crohn’s disease.”
To avoid death regardless of cause during the same ten-year period, the number of treated patients dropped to 20, on account of how statins also protect against more common conditions, such as cardiovascular disease. Statins were linked to fewer deaths in both ulcerative colitis and Crohn's disease patients.
The study was based on the ESPRESSO-cohort, which is run by its initiative-taker Jonas F Ludvigsson, paediatrician at Örebro University Hospital and professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, and the study’s last author.
“In that we can combine tissue data from patients with colorectal cancer with data from Swedish health registries, we’re uniquely placed to study the long-term effects of drugs for IBD,” he says. “Our hope is that these studies will improve the care of IBD patients.”
According to the researchers, the new results provide the most solid evidence so far that statins could be an effective prophylactic for colorectal cancer among people with IBD. However, more knowledge must be gathered before the treatment can be recommended in general guidelines.
“More studies are needed to ascertain if there is a causal relationship, at what point of the pathological process statins should be administered, what a reasonable dose would be and how long treatment needs to last if it’s to be of benefit,” said Dr Sun.
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