13 Oct Do Statins Raise Risk of Skin Infections?

MedicalResearch.com Interview with:
Hean Teik Humphrey Ko PhD candidate
School of Pharmacy and Biomedical Sciences
Faculty of Health Sciences, Curtin University
Perth, Western Australia, Australia

MedicalResearch.com: What is the background for this study?

Response: Bacterial skin infections consume precious healthcare resources because such infections are common and may sometimes be severe. Statins are relatively affordable and extensively prescribed worldwide to prevent cardiovascular diseases. Additionally, the safety/adverse effects of statins have been well documented.

Staphylococcus aureus is a major cause of bacterial skin infections, and statins have been separately reported to exert antibacterial effects against S. aureus, as well as reduce the risk of S. aureus related blood infections. As such, it seemed plausible that statins may prove beneficial in S. aureus related skin infections. However, statins may also induce new-onset diabetes mellitus, a condition which in turn, is a risk factor for skin infections.

Therefore, in order to determine if statins could potentially serve as a novel therapeutic agent for skin infections to reduce healthcare costs, this study was conducted to examine the interrelationships between statins, diabetes, and skin infections. 

MedicalResearch.com: What are the main findings? 

Response: Utilising sequence symmetry analysis, a method gaining popularity in pharmacoepidemiology to detect adverse events (skin infections/diabetes in this study), it was found that the use of statins over as little as 91 days was associated with an increased risk of skin infections via direct (non-diabetogenic) and indirect (diabetogenic) mechanisms. The increased risk of skin infections appeared unbiased by diabetes or socioeconomic statuses.  

MedicalResearch.com: What should readers take away from your report?

Response: The widespread use of statins will likely continue with guidelines across the world recommending statin use for prevention of cardiovascular diseases. Hence, there is a need for clinicians to be mindful that statin use may be associated with diabetes, as well as a possible increased risk of skin infections. Statin users who are predisposed to diabetes would thus likely benefit from blood glucose monitoring

 MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response:

Further clinical studies are required to confirm our postulated mechanisms accounting for the increased risk of skin infections:

1. Reduction of innate immunity via an increase of T regulatory cells and inhibition of Th1 and Th17 cells within 91 days (direct mechanism).
2. Reduction of low density lipoprotein cholesterol and coenzyme Q10 levels within 91 days of statin commencement, which increased the risk of diabetes, in turn a risk factor for skin infections (indirect mechanism).

Future research on mechanisms which could not be verified in this study may include:

1. Statins’ influence on the human gut microbiome, possibly increasing the risk of diabetes via pregnane X receptor activation.
2. Statins’ effect on vitamin D levels, influencing the risk of diabetes.

MedicalResearch.com: Is there anything else you would like to add?

Response: Since statins have been found to possess inherent antibacterial activity against bacteria such as S. aureus, it might be worthwhile to determine the mechanism(s) of statins’ antibacterial action(s), and investigate if the widespread use of statins might contribute towards antimicrobial resistance.

We have no competing interests to declare.

Citation:

Br J Clin Pharmacol. 2019 Oct 8. doi: 10.1111/bcp.14077. [Epub ahead of print]

A sequence symmetry analysis of the interrelationships between statins, diabetes and skin infections.

Ko HHT Lareu RR Dix BR, Hughes JD, Parsons RW.

https://www.ncbi.nlm.nih.gov/pubmed/31595525 

Last Modified: [last-modified] 

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Last Updated on October 14, 2019 by Marie Benz MD FAAD