Michael O’Grady*, Louise Clarke, Gregory Turner, Matt Doogue, Frank Frizelle and Rachel Purcell
Objective: To examine the association between statin use and the development of acute diverticulitis requiring hospital admission.
Methods: A retrospective, population-based, case–control study was carried out on a cohort of adults, resident in Canterbury, New Zealand between 1-1-2003 and 31-1-2008, identified from the National Census; all identified cases were admitted to hospital and had CT confirmed diverticulitis. The positive control group comprised patients on nonaspirin non-steroidal anti-inflammatory drugs (NSAIDs), and the negative control group were patients on selective serotonin reuptake inhibitors (SSRIs). Medicine exposure was obtained from the Pharmaceutical Management Agency of New Zealand. Subgroup analysis was done by age and for complicated diverticulitis and recurrent diverticulitis.
Results: During the study period, there were 381,792 adult’s residents in Canterbury. The annual incidence of diverticulitis requiring hospital presentation was 18.6 (<65 years, 13.1;>64 years, 41.3) per 100,000 per year. Complicated disease was seen in 37.4% (158) of patients, and 14.7 % (62) had recurrent disease. Statins were not found to affect the risk of developing acute diverticulitis, nor the risk of complicated or recurrent diverticulitis. Subgroup analysis suggested statin use was associated with a decreased risk of acute diverticulitis in the elderly (age>64 years). NSAIDs were associated with a decreased risk of acute diverticulitis (RR=0.65, CI: 0.26–0.46, p<0.001), as were SSRIs (RR=0.37, CI: 0.26 – 0.54, p<0.001).
Conclusion: This population-based study does not support the hypothesis that statins have a preventative effect on the development of diverticulitis, including complicated disease. We also found a decreased risk of diverticulitis associated with NSAID and SSRI use.
Keywords: Diverticulitis; Statins; Non-steroid anti-inflammatory drugs (NSAID); Selective serotonin re-uptake inhibitors (SSRI); Complicated diverticulitis; Recurrent diverticulitis
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