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Meta-Analysis
. 2024 Aug;30(8):e14888.
doi: 10.1111/cns.14888.

Determining the role of statins in Parkinson's disease risk reduction and disease modification: A comprehensive meta-analysis of 4 million participants' data

Abdelrahman Mady  1   2 , Yehia Nabil  1   3 , Asma Daoud  4   5 , Asmaa Zakria Alnajjar  6   7 , Taleb Alsalloum  8   9 , Menna Marwan  1   10 , Maickel Abdelmeseh  1   11 , Moaz Elsayed  1   12 , Abdulrahman Krayim  1   2 , Mohamed Alaa  1   13 , Mahmoud Masoud  1   14 , Nagham Bushara  1   3 , Roaa Faisal  15   16 , Hayat Ahmed  15   17 , Mohamed Saad  1   18 , Zineddine Belabaci  4   19 , Matthew J Barrett  20 , Brian Berman  20 , Ahmed Negida  1   20
Affiliations
Meta-Analysis

Determining the role of statins in Parkinson's disease risk reduction and disease modification: A comprehensive meta-analysis of 4 million participants' data

Abdelrahman Mady et al. CNS Neurosci Ther. 2024 Aug.

Abstract

Background: Many observational studies have examined the association between statins and the incidence of Parkinson's disease (PD) in high-risk populations. On the other hand, clinical trials as well as other observational studies investigated the safety and efficacy of statins in slowing disease progression in PD patients. However, the evidence has been inconclusive in both questions. To that end, we conducted this systematic review and meta-analysis to synthesize evidence on the role of statins in decreasing the risk of PD among high-risk populations and as a possible disease-modifying agent for patients with PD.

Methods: A comprehensive literature search of electronic databases including PubMed, Scopus, Cochrane, and Web of Science has been performed. Relevant studies were chosen and data were extracted and analyzed using RevMan software version 5.4.1.

Results: Twenty-five studies (14 cohort, 9 case-control, and 2 randomized controlled trials) have been included in the present systematic review. Of them, 21 studies reported the association between statins and PD risk. Statins were found to significantly reduce the risk of developing PD (pooled RR 0.86, 95% CI [0.77-0.95], p < 0.005). Four studies investigated statins as a disease-modifying agent. The pooled mean difference (MD) in the UPDRS-III from baseline to endpoint did not differ significantly between the statin and control groups (MD -1.34 points, 95% CI [-3.81 to 1.14], p = 0.29).

Conclusion: Although epidemiological observational studies showed that statin use was associated with a reduced risk of PD, current evidence is insufficient to support the role of statins in slowing the progression of PD. These findings are limited by the fact that most of the included studies are observational studies which carry a high risk of confounding bias which highlights the need for future well-designed RCTs.

Keywords: Parkinson's disease; disease risk; hydroxymethylglutaryl‐coenzyme A reductase inhibitors; meta‐analysis; statins; symptom progression.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram showing the details of the study selection process.
FIGURE 2
FIGURE 2
Main meta‐analysis results for the first research question (the association between statins and PD risk).
FIGURE 3
FIGURE 3
Funnel plot for assessing publication bias for the first research question (the association between statins and PD risk).
FIGURE 4
FIGURE 4
Meta‐analysis results of the second research question (the effect of statins on PD symptoms progression).
FIGURE 5
FIGURE 5
Sensitivity analysis results after removing the Stevens 2022 study.
See this image and copyright information in PMC

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