Millions of people take statins to lower their cholesterol, and new research suggests these drugs may also ease ulcerative colitis.
An inflammatory bowel disease with no real cure, ulcerative colitis causes sore spots on the lining of the colon that can lead to rectal bleeding, diarrhea and cramping. Treatment typically involves anti-inflammatory drugs and/or removal of part or all of the colon (colectomy). Ulcerative colitis affects nearly 1 million Americans.
“Statins have been known to have an anti-inflammatory effect for quite some time,” said lead researcher Purvesh Khatri, an associate professor of medicine and biomedical data science at Stanford University. “Our study provides strong evidence in support of further investigations to identify the mechanism of action.”
It found that patients with ulcerative colitis who were also taking atorvastatin (Lipitor) were less likely to be hospitalized and had about a 50% decrease in colectomy rates.
Khatri said the finding is significant as fully 30% of people with ulcerative colitis eventually undergo the procedure.
Exactly how, or even if, statins affect ulcerative colitis is not fully understood yet, researchers emphasized.
For the study, they analyzed genetic data from hundreds of patients who had undergone a colon biopsy. Then they used data from lab studies to investigate how certain approved drugs reversed the genetic signature of ulcerative colitis.
Three drugs seemed to do the trick: two were chemotherapy drugs and the other was atorvastatin. Researchers said chemotherapy drugs have too many side effects to be considered for this purpose.
A review of electronic health records of people revealed that long-term use of atorvastatin provided more protection than short-term use.
“Our results support additional investigation into the use of atorvastatin for treating patients with ulcerative colitis,” Khatri said. “Trials are needed to confirm whether and how much atorvastatin treatment would benefit patients with ulcerative colitis.”
Researchers said they plan to see if the benefits hold with other available statins.
The findings will appear Sept. 16 in the Journal of the American Medical Informatics Association.
Outside experts who weighed in after reviewing the findings caution that it’s too soon to draw any conclusions about what role statins may play in treating ulcerative colitis.
But given the scarcity of treatment options, the study is a “welcome experiment to see if a commonly used medication, the cholesterol drug atorvastatin, could be used for ulcerative colitis,” said Dr. Elena Ivanina, director of neurogastroenterology and motility at Lenox Hill Hospital in New York City.
“Atorvastatin has been shown to have anti-inflammatory effects including the reduction of colitis in animal models of inflammatory bowel diseases, therefore, reinforcing that this medication could be a potential treatment,” she said.
But Ivanina added that large clinical trials will be required to understand if atorvastatin does have an impact on ulcerative colitis and colectomy rates.
Dr. Hamed Khalili, associate director of the clinical and translational epidemiology unit at Massachusetts General Hospital in Boston, agreed.
“I think this kind of innovation is helpful because it explores the potential therapeutic role of established and already approved medications for ulcerative colitis,” he said. “The data is too preliminary to recommend statin as a treatment and more studies are needed.”
The American College of Gastroenterology offers more on ulcerative colitis and its treatments.
SOURCES: Purvesh Khatri, PhD, associate professor, medicine and biomedical data science, Stanford University, California; Elena Ivanina, DO, MPH, director, neurogastroenterology and motility, Lenox Hill Hospital, New York City; Hamed Khalili, MD, MPH, gasterenterologist and associate director, clinical and translational epidemiology unit, Massachusetts General Hospital, Boston; Journal of the American Medical Informatics Association, Sept. 16, 2021