Nature communications · 2024
Myasthenia gravis following statin therapy: evidence from target trial emulation and self-controlled case series study.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Xu Wanchun, Yan Vincent Ka Chun, Zhang Zhijuan, Fung Kwun Kei, Chan Koon Ho, Lau Kui Kai, Chui Celine Sze Ling, Lai Francisco Tsz Tsun, Li Xue, Chan Esther Wai Yin, Wong Ian Chi Kei, Wan Eric Yuk Fai
Аннотация
Several international pharmacovigilance agencies have issued warnings regarding the potential risk of myasthenia gravis (MG) following statin therapy. Our study investigated this association using population-based electronic health records in Hong Kong. We conducted a sequence of target trial emulation (TTE) for interpersonal comparison and a self-controlled case series (SCCS) study for intrapersonal comparison. In the TTE for MG onset, the incidence rates (per 100,000 person-years) and adjusted HRs were 51.91(31.80, 84.74)[HR:6.11 (3.73, 10.01)] in month 1, 16.27(9.81, 26.99)[HR:1.92(1.15, 3.19) in months 2-4, and 15.27(9.05, 25.79)[HR:1.80(1.06, 3.04)] in months 5-7. For risk of exacerbation, the adjusted HRs were 10.69(5.48, 20.84) in month 1, 1.50(0.55, 4.06) in months 2-4, and 2.79(1.33, 5.84) in months 5-7. No increased risks were found during the subsequent 18 months. A similar pattern was observed in SCCS analysis. Our findings recommend a minimum monitoring period of approximately six months for MG symptoms for patients starting using statin.