Electronic Theses and Dissertations

Title

Do Statins Improve Outcomes in Patients With Asthma on Inhaled Corticosteroid Therapy? A Retrospective Analysis of the Mississippi Medicaid Database 2002-2004.

Date of Award

2011

Document Type

Dissertation

Degree Name

M.S. in Pharmaceutical Science

First Advisor

Donna West-Strum

Second Advisor

Yi Yang

Third Advisor

John P. Bentley

Abstract

Animal model studies and clinical trials have looked at the potential benefits of the anti-inflammatory properties of statins in asthma management with contradictory results. Therefore, the objective of this study is to determine if asthma patients on concurrent statin therapy are less likely to have asthma-related hospitalizations and emergency room (ER) visits. We conducted a retrospective cohort study using Medicaid data for 2002–2004. Asthma patients ?18 years old were identified using the ICD9 code 493.xx, from Jul 1, 2002 through Dec 31, 2003. The index date for an exposed subject was any date within the identification period, 180 days prior to which the subject had at least 1 inhaled corticosteroid (ICS) prescription and at least an 80% adherence rate to statins. Medicaid beneficiaries identified as asthmatics and on ICS therapy, but not on statins were selected as the unexposed population. Each subject in the exposed group was matched to 2 subjects from the unexposed population using propensity scores computed using age, gender, race, urban/rural region and Charlson Comorbidity Index. The two groups were followed for 1 year beginning on the index date, and their outcomes in terms of hospitalizations and ER visits were compared using conditional logistic regression, further adjusted for adherence to ICS therapy, average number of short-acting ? agonists per subject, prior hospitalizations, ER, lab and office visits due to asthma. After matching, there were 479 exposed subjects with 958 corresponding controls. After adjusting for the above mentioned covariates, asthma patients not on concurrent statin therapy are almost two times as likely to have hospitalization and/or ER visits or both due to asthma (adjusted OR = 0.55; 95% CI [0.37, 0.84]; p = 0.0059), in comparison to patients on statin therapy. Similarly, they are also twice as likely to visit the ER due to asthma exacerbations as patients on statins (adjusted OR = 0.48; 95% CI [0.28, 0.82]; p = 0.0069). The findings of this study suggest that there may be beneficial effects of statins in preventing asthma exacerbations. Further prospective investigations are required to provide conclusive evidence.

Concentration/Emphasis

Pharmaceutics

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