(155) Statin Discontinuation in Persons with and Without Alzheimer's Disease

Saturday, August 27, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 829

Presenting Author(s)

Heidi Taipale, PharmD
– Senior Researcher, Niuvanniemi Hospital, Niuvanniemi Hospital (FIN), Karolinska Institutet (SWE), Kuopio, Pohjois-Savo, Finland

Co-Author(s)

Mai Thi Phuong Vu
– University of Eastern Finland, Kuopio, Pohjois-Savo, Finland
Raimo Kettunen
– Clinician, School of Medicine, University of Eastern Finland, Kuopio, Finland, Finland
Anna-Maija Tolppanen
– professor, Kuopio, Pohjois-Savo, Finland
Sirpa Hartikainen
– Professor, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, Kuopio, Pohjois-Savo, Finland

Background: Although prevalence of statin use is reported to decrease after dementia diagnosis, time to statin discontinuation and factors associated with discontinuation have not been studied in persons with Alzheimer’s disease (AD).

Objectives: To assess the risk of discontinuation and factors associated with discontinuation including secondary and primary prevention indication, in statin users with and without AD.

Methods: The nationwide register-based cohort study was conducted using Medication Use and Alzheimer’s disease (MEDALZ) cohort including 70718 community dwellers with a clinically verified AD diagnosed during 2005–2011 in Finland. People with and without AD who were using statins on the date AD diagnosis or initiated within 90 days after were included in the study. They were followed up to statin discontinuation, long-term (>90 days) hospitalization, death, date when comparison people got AD diagnosis, after 4 years, or end of data linkage, whichever came first. Cox regression models were used to compare the risk of statin discontinuation between persons with and without AD and the model was adjusted for age at cohort entry, sex, statin use before cohort entry, indication, sum of cardiovascular drug substances, diabetes, atrial fibrillation, heart failure, calendar year, and hospital district

Results: There were 25137 statin users with AD and 22692 without AD included in the study. The median time to statin discontinuation was 1.46 years in people with AD and 1.36 years in people without AD. People with AD were more likely to discontinue than people without AD (adjusted HR (aHR) 1.20 (95% CI 1.18-1.24)). This was observed for both primary (aHR 1.11 (1.06-1.16)) and secondary prevention (aHR 1.30 (1.25-1.35)) purpose. Factors associated with discontinuation included higher age and female gender, whereas concomitant cardiovascular drug use and previous statin use were associated with decreased risk.

Conclusions: The absolute difference in discontinuation rates was small, and the same factors were associated with statin discontinuation in people with and without AD. The findings suggest that cognitive decline plays a minor role in statin discontinuation.