Relationship of statins and other cholesterol-lowering medications and risk of amyotrophic lateral sclerosis in the US elderly
Abstract
Objective Statins are commonly prescribed drugs that have been inconsistently associated with amyotrophic lateral sclerosis (ALS) risk. We examined associations between ALS risk and overall statin use, statin categories based on lipophilicity and other cholesterol-lowering medications, in Medicare beneficiaries. Methods In this nation-wide population-based case-control study, 10,450 Medicare participants (ages 66-89 years) diagnosed with ALS, using Medicare Parts A and B claims, between 1 January 2008 and 31 December 2014, were frequency-matched to 104,500 controls on age, sex, and selection year. Odds ratios (ORs) for the association between statins and ALS were estimated using logistic regression models. Covariates included dyslipidemia, other comorbidities, age, sex, race, proxies for smoking and obesity, Medicare use, and indicators of socioeconomic status. Statin use derived from Medicare Part D claims. Non-statin cholesterol-lowering drugs were evaluated as comparison drugs. Results ALS risk was reduced with statin use (OR = 0.87 (95% confidence interval (CI) = 0.83-0.91)). While risk was unrelated to three cholesterol-lowering medications (nitrates, bile acid sequestrants, and ezetimibe), it was associated with fibrates (OR = 0.88 (95% CI = 0.80-0.97)). Risk for lipophilic statins was slightly lower than for other statins. ALS risk was lower in all statin categories for dyslipidemic individuals, but only lipophilic statins were associated with lower risk in non-dyslipi…
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Previous research by the authors' group and others has found a null or inverse association between statin use and ALS risk.
“Previous research by our group and others has found a null or inverse association between statin use and ALS risk [33, 34].”
From Lifestyle and medical conditions in relation to ALS risk and progression—an introduction to the Swedish ALSrisc Study (2024) · cites this paper as [33]
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- Authors
- Freedman, D. M., Kuncl, R. W., Cahoon, E. K., Rivera, D. R., & Pfeiffer, R. M.
- Affiliations
- National Institutes of Health (US)
- University of Redlands (US)
- United States Department of Health and Human Services (US)
- Corresponding author
- Pfeiffer, Ruth M.
- Venue
- Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
- Publisher
- Informa UK Limited
- Published
- 2018-10-02
- Volume
- 19
- Issue
- 7-8
- Pages
- 538-546
- ISSN
- 2167-8421 (ISSN-L)
- 2167-9223
- OpenAlex
- W2903550412
- Cited by
- 28
- References
- 43
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 2 · 2023: 3 · 2022: 5 · 2021: 4 · 2020: 5 · 2019: 1
- FWCI
- 2.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Intramural Research Program of the National Institutes of Health
- National Cancer Institute
- US Public Health Service
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
- Keywords
- amyotrophic lateral sclerosis, statins, cholesterol-lowering drugs, fibrates, lipophilic statins, dyslipidemia, drug safety, older adults, Medicare beneficiaries, bile acid sequestrants, ezetimibe, nitrate
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Amyotrophic Lateral Sclerosis, Anticholesteremic Agents, Female, Humans, Male, Retrospective Studies, United States, Logistic Models, Odds Ratio, Case-Control Studies, Community Health Planning
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