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 107,689 statin users and 433,067 non-statin users. After propensity score-matching, 26,036 statin users and the same number of non-statin users were finally analyzed. The development of active TB was monitored in these matched pairs over the 11 years from 2003 to 2013.
Results: The number of active TB cases was 150 in 31,645 person-years (4.74 per 1,000 person-years; 95% CI, 3.98 to 5.50) in the statin users, and 902 in 153,401 person-years (5.88 per 1,000 person-years; 95% CI, 5.50 to 6.26) in the non-statin users. Statin users had a significantly lower risk of TB than non-statin users: hazard ratio (HR) 0.78 (95% CI, 0.65 to 0.93) (p = 0.006). A subgroup analysis showed that statin use reduced the risk of TB significantly in subjects without diabetes but not in subjects with diabetes: HRs were, respectively, 0.73 (95% CI, 0.56 to 0.95) (p = 0.018) and 0.83 (95% CI, 0.54 to 1.28) (p = 0.40).
Conclusion: These epidemiologic findings provide strong evidence that statin use decreases the risk of active TB. The protective effect of statins against TB was attenuated by diabetes. Further studies about the effect of statins on TB incorporating experimental and clinical researches are required.
M. C. Kim,
S. H. Kim, the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI): Investigator , Grant recipient .