Statin Use Associated with Decreased CRS Rates in U.S. Outpatient Visits

Is there an association between statin use and inflammatory reduction in the treatment of chronic rhinosinusitis (CRS)?

Bottom line: Statin use is associated with decreased rates of CRS based on a nationally representative sample of outpatient visits in the United States.

Background: Regardless of etiology, all CRS cases result in chronic inflammation of the paranasal sinuses and upper airway, which has led researchers to investigate the role of anti-inflammatory medications in treatment. Research suggests that statins may have anti-inflammatory effects via modulation of lipid-containing enzymes and mediators, but no studies have been conducted to investigate whether statins have clinical utility in treating CRS.

Study design: Retrospective database review of 390,538 unweighted visit records, corresponding to 9,612,613,668 weighted visits.

Setting: 2006 to 2015 National Ambulatory Medical Care Survey (NAMCS) database.

Synopsis: Of the reviewed records, there were an estimated 1,014,461,419 visit records of patients taking a statin and an estimated 147,492,330 visit records with a diagnosis of CRS. Among those taking a statin, CRS accounted for an estimated 0.87% of visit records. By comparison, CRS accounted for an estimated 1.61% of visit records among those not taking a statin. In a univariate regression analysis, statin use was associated with a decreased CRS prevalence; in a multivariate regression analysis accounting for demographic factors and comorbidities, statin use remained a negative predictor for CRS. Limitations included a lack of all potentially relevant comorbid conditions in the multivariate model, the database’s inclusion of only visits to office-based, non-federally employed physicians, lack of confirmation of CRS diagnosis from these data, reliance on the accuracy of ICD-9 codes, and the establishment of an association, rather than causality, between statin use and CRS prevalence.

Citation: Wilson JH, Payne SC, Fermin CR, Churnin I, Qazi J, Mattos JL. Statin use protective for chronic rhinosinusitis in a nationally representative sample of the United States. Laryngoscope. 2020;130:848-851.