by Colleen Fleiss on September 3, 2023

Statins, medications that reduce cholesterol levels, may offer a safeguard to people with ulcerative colitis by potentially preventing the onset of colorectal cancer and reducing the death risk, stated study by researchers at Karolinska Institutet in Sweden and published in eClinicalMedicine. 

Colo-rectal cancer - Management


Treatment for Colorectal Cancers may involve surgery,chemotherapy, radiation therapy or biological therapy. Some people require a combination of treatments.


"Even though more studies are needed to confirm our results, our study suggests that statins can prevent colorectal cancer in patients with inflammatory bowel disease (IBD), which is a high-risk group for this kind of cancer," says the study's first author Jiangwei Sun, researcher at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.

The observational study conducted by Dr. Sun and his colleagues compared over 10,500 IBD patients from around the country, of whom half were statin users; the other half of the group, who were matched with the first, were not. After a follow-up period of, on average, 5.6 years, 70 of the statin group and 90 of the non-statin group had been diagnosed with colorectal cancer.

Statins


Statins are new wonder drugs that are proving to be efficacious, not merely in relieving symptoms but also offering several health benefits.


The protective effect was directly proportional to the length of time the patient had been on statins and could be demonstrated after two years' treatment.

There were also fewer deaths from colorectal cancer in the statin group (20) than in the non-statin group (37) during the study period, and deaths regardless of cause (529 versus 719).

Statins Benefit Ulcerative Colitis Patients

The study shows that some 200 IBD patients need to be treated with statins to avoid one case of colorectal cancer or death from the cancer within ten years of treatment onset. The protective effect was only statistically valid for patients with ulcerative colitis.

"We think this is because the study contained fewer patients with Crohn's disease," explains Dr. Sun. "More and larger studies compiling data from patient populations in many countries will probably be needed to achieve statistical significance for Crohn's disease."

To avoid death regardless of cause during the same ten-year period, the number of treated patients dropped to 20, on account of how statins also protect against more common conditions, such as cardiovascular disease. Statins were linked to fewer deaths in both ulcerative colitis and Crohn's disease patients.

The study was based on the ESPRESSO-cohort, which is run by its initiative-taker Jonas F Ludvigsson, pediatrician at Örebro University Hospital and professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, and the study's last author .

"In that we can combine tissue data from patients with colorectal cancer with data from Swedish health registries, we're uniquely placed to study the long-term effects of drugs for IBD," he says. "Our hope is that these studies will improve the care of IBD patients."

"More studies are needed to ascertain if there is a causal relationship, at what point of the pathological process statins should be administered, what a reasonable dose would be and how long treatment needs to last if it's to be of benefit," says Dr. Sun.

The study was conducted with researchers from several institutions, including Örebro University in Sweden and Harvard University in the USA. It was financed by the Swedish Research Council for Health, Working Life and Welfare (Forte). Some of the authors report links to various companies. Jonas Halfvarson, Ola Olén and Jonas F Ludvigsson report former relations with a number of pharmaceutical companies. Paul Lochhead is an employee of GSK. All other authors report no conflicts of interest.

Reference :

  1. Statin use and risk of colorectal cancer in patients with inflammatory bowel disease -(https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00359-0/fulltext)

  2. ESPRESSO -(https://ki.se/en/meb/espresso)