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. 2018 Jun 14;13(6):e0198263.
doi: 10.1371/journal.pone.0198263. eCollection 2018.

Statins increase the risk of herpes zoster: A propensity score-matched analysis

Min-Chul Kim  1 , Sung-Cheol Yun  2 , Sang-Oh Lee  3 , Sang-Ho Choi  3 , Yang Soo Kim  3 , Jun Hee Woo  3 , Sung-Han Kim  3
Affiliations

Statins increase the risk of herpes zoster: A propensity score-matched analysis

Min-Chul Kim et al. PLoS One. .

Abstract

Objectives: Statins, which are lipid-lowering agents, have anti-inflammatory and immunomodulatory properties that may affect the occurrence of various infectious diseases. We assessed whether statins increase the risk of herpes zoster (HZ) with propensity score-matching.

Methods: The study was based on the National Health Insurance database and its subset database of the "medical check-up" population of South Korea. These cohorts consist of about one million and 570,000 people, respectively, representative of the entire population of South Korea. We identified 103,930 statin users and 430,685 non-statin users. After propensity score-matching, 25,726 statin users and the same number of non-statin users were finally analyzed. The development of HZ was monitored in these matched pairs over the 11 years from 2003 to 2013.

Results: Statin users had a significantly higher risk of HZ than non-statin users: hazard ratio (HR) 1.25 (95% CI, 1.15 to 1.37) (p < .0001). The risk of HZ associated with statins was especially high in the elderly: HR 1.39 (95% CI, 1.12 to 1.73) in the over 70-year-olds (p = 0.003) and HR 1.18 (95% CI, 1.00 to 1.39) in the 60-to-69-year-olds (p = 0.056). Furthermore, there was a significant p for trend in terms of cumulative dose effect between the risk of HZ and the duration of statin use (p < .0001).

Conclusions: These epidemiologic findings provide strong evidence for an association between HZ and statin use, and suggest that unnecessary statins should be avoided.

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Conflict of interest statement

There are no potential conflicts of interest for any authors.

Figures

Fig 1
Fig 1. Flow diagram of the study.
Flow diagram giving details of the enrolled individuals, and the procedure for propensity score matching.
Fig 2
Fig 2. Cumulative incidences of herpes zoster (%) according to the use of statins.
Kaplan–Meier curves showing cumulative incidences (%) of individuals suffering from herpes zoster. Red line indicating herpes zoster in statin users. Blue line depicting herpes zoster in non-statin users. The difference between statin users and non-statin users was significant (p < .0001 by the log rank test).
See this image and copyright information in PMC

References

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