Myasthenia gravis following statin therapy: evidence from target trial emulation and self-controlled case series study
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.
Authors
- Celine Sze Ling Chui (ORCID: https://orcid.org/0000-0003-1513-8726)
- Wanchun Xu (ORCID: https://orcid.org/0000-0002-6183-571X)
- Eric Yuk Fai Wan (ORCID: https://orcid.org/0000-0002-6275-1147)
- Kui Kai Lau (ORCID: https://orcid.org/0000-0002-8657-2418)
- Esther W. Chan (ORCID: https://orcid.org/0000-0002-7602-9470)
- Francisco Tsz Tsun Lai (ORCID: https://orcid.org/0000-0002-9121-1959)
- Vincent Ka Chun Yan (ORCID: https://orcid.org/0000-0001-5225-3032)
- Ian Chi Kei Wong (ORCID: https://orcid.org/0000-0001-8242-0014)
- Philip Wing‐Lok Ho (ORCID: https://orcid.org/0000-0001-7794-0146)
- Xue Li (ORCID: https://orcid.org/0000-0003-4836-7808)
- Zhijuan Zhang
- K. K. Fung
Institutions
- Macau University of Science and Technology (MO)
- Aston University (GB)
- Queen Mary Hospital (CN)
- Hong Kong Science and Technology Parks Corporation (HK)
- City University of Hong Kong, Shenzhen Research Institute (CN)
- University of Hong Kong - Shenzhen Hospital (CN)
- HKU-Pasteur Research Pole (HK)
- Laboratory of Data Discovery for Health (HK)
- University of Hong Kong (HK)
Publication Details
- Journal
- Nature Communications
- Published
- 2024-11-28
- DOI
- https://doi.org/10.1038/s41467-024-54097-1
- Citations
- 5
- Primary Topic
- Myasthenia Gravis and Thymoma
- Type
- article
- Field-Weighted Citation Impact
- 1.85
Funders
- Impact Fund
- Pfizer
- National Natural Science Foundation of China
- Innovation and Technology Commission
- University of Hong Kong
- Medical Research Council
- National Health and Medical Research Council
- Health and Medical Research Fund
- Young Scientists Fund