Language

English

Publication Date

4-1-2025

Journal

Clinical and Translational Gastroenterology

DOI

10.14309/ctg.0000000000000816

PMID

40272937

PMCID

PMC12020706

PubMedCentral® Posted Date

1-21-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Introduction: Patients with primary sclerosing cholangitis (PSC) are at increased risk of acute cholangitis. The epidemiological risks of cholangitis are poorly studied despite the high morbidity associated with this infection. The aim of this study was to understand the impact of statins on acute cholangitis in PSC.

Methods: This multicenter, retrospective cohort study assessed data from 294 patients with PSC at Stanford Medical Center, Baylor Medical Center, and Valley Medical Center. Clinical factors associated with the development of cholangitis were identified using multivariable Cox regression.

Results: The patients were predominantly male (68.7%) with a median age at enrollment of 48 years (interquartile range [IQR]: 31.0-60.8). Fifty patients (17.0%) were prescribed statins. The median follow-up time was 6 years (IQR: 2.0-12.0), in which 29.6% (n = 87) developed cholangitis. In multivariable analysis, statins were associated with an 81% reduction in cholangitis (HR 0.19, 95% confidence interval 0.03-0.64). Statins were associated with a lower adjusted incidence of cholangitis at 36 months compared with patients not on statin therapy (incidence of 2.8% vs 12.2%, P < 0.001). Statins were also associated with increased time-to-stricture ( P = 0.004), an outcome known to be associated with PSC complications.

Discussion: Statin therapy is associated with reduced risk of cholangitis in PSC, possibly by delaying the time to develop dominant or high-grade strictures. In patients with PSC, use of statin therapy may be a beneficial modality to prevent the development of cholangitis and warrants further investigation.

Keywords

Humans, Male, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Retrospective Studies, Female, Cholangitis, Sclerosing, Middle Aged, Adult, Cholangitis, Acute Disease, Incidence, Risk Factors, Follow-Up Studies, primary sclerosing cholangitis, acute cholangitis, statins, dominant stricture

Published Open-Access

yes

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