Statin use increased the risk of herpes zoster

Exposure to statins can significantly increase the odds of developing herpes zoster, a study showed.

The mechanisms by which statins may increase the risk of HZ (herpes zoster) are not established. As statins are commonly prescribed worldwide, any adverse effects may have substantial public health implications.

Subjects for this matched, case-control study were drawn, with adults aged 18 years and over with HZ identified and linked with their corresponding data in the  Statistics database from Jan. 1, 2000, through Dec. 31, 2011.

Each subject was matched with no more than four control patients all of whom had no prior history of HZ or post herpetic neuralgia-selected from the same databases. Matching was based on the following criteria: subject’s general practitioner (GP) practice, age (within one year of the HZ patient), sex, and lack of prior statin exposure. Ultimately 144,959 subjects were matched with 549,336 controls.

The primary outcome was defined as incident diagnoses of HZ, which was measured via odds ratios calculated from conditional logistic regression models and adjusted for any potential confounding factors. In addition, ORs were calculated to  “explore the association between the risk of HZ and the dosage of the latest prescription (low, medium, high), stratified by time since last exposure.

The results showed an adjusted OR of 1.13 for HZ, after any kind of statin treatment, indicating a significant increase in risk. There was also a higher adjusted OR for those who had stopped using statins 12-36 months prior to the study than for those whose last exposure was greater than 36 months prior. (P less than .001). Those whose current statin usage was “medium” and 1.14 for those whose usage was “low” (P less than .001).

It is clear that the preventive benefits of statin therapy are likely to outweigh the limited increase in HZ risk in many cases, (but) this evidence should be taken into account by GPs when prescribing statins to those at high risk of HZ. We would also suggest that there may be an extra motivation to maximize HZ vaccine uptake among eligible patients who are also receiving a statin.