Ulcerative Colitis Resource Center

Ulcerative Colitis Resource Center

Perspective from Benjamin Cohen, MD, MAS
Disclosures: Khatri reports being funded in part by the Bill and Melinda Gates Foundation (OPP1113682); the National Institute of Allergy and Infectious Diseases (NIAID) grants 1U19AI109662, U19AI057229, and 5R01AI125197; Department of Defense contracts W81XWH-18-1-0253 and W81XWH1910235; and the Ralph & Marian Falk Medical Research Trust. Please see the study for all other authors’ relevant financial disclosures.
September 16, 2021
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Lipitor reduces colectomy rate in ulcerative colitis

Perspective from Benjamin Cohen, MD, MAS
Disclosures: Khatri reports being funded in part by the Bill and Melinda Gates Foundation (OPP1113682); the National Institute of Allergy and Infectious Diseases (NIAID) grants 1U19AI109662, U19AI057229, and 5R01AI125197; Department of Defense contracts W81XWH-18-1-0253 and W81XWH1910235; and the Ralph & Marian Falk Medical Research Trust. Please see the study for all other authors’ relevant financial disclosures.
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Lipitor may be a novel therapeutic option in patients with ulcerative colitis, according to study results published in Journal of the American Medical Informatics Association.

“Long-term atorvastatin (Lipitor) use is associated with reduced rate of colectomy in patients with UC,” Purvesh Khatri, PhD, from the Institute for Immunity, Transplantation and Infection, School of Medicine, Stanford University in California, told Healio Gastroenterology. “Our results also suggest that it may also be associated with lower rates of hospitalization and new steroid prescriptions.”

Khatri and colleagues identified an ulcerative colitis disease gene signature by conducting a multi-cohort analysis of 272 colon biopsy transcription samples from 11 public datasets. To identify potential drug targets, researchers compared the gene signature with in vitro transcriptomic profiles induced by 781 FDA-approved drugs. To determine the protective impact of predicted drugs on colectomy risk in patients with UC from the Stanford Research Repository (STARR) database and Optum Clinformatics DataMart, investigators modeled a retrospective cohort study designed after a target trial.

Among non-oncolytic FDA-approved therapies, results showed atorvastatin treatment had the highest inverse-association with the ulcerative colitis gene signature. Atorvastatin intake in both STARR (n = 827) and Optum (n = 7,821), correlated with a decreased risk for colectomy, a marker of treatment-refractory disease, compared with patients prescribed a comparator drug (STARR: HR = 0.47, P = .03; Optum: HR = 0.66, P = .03), regardless of age and length of atorvastatin treatment.

“All data used in our manuscript are retrospective cohorts,” Khatri told Healio Gastroenterology. “Therefore, the next step is to validate this finding in a cohort of prospectively enrolled patients. Further, our results suggest that the protective effect is also observed with other statins, but we did not have enough patients treated with other statins to derive a conclusion. Hence, one of the next steps is to understand whether the protective effect is atorvastatin-specific or general to all statins. The other issues to think through are the dose and duration patients with ulcerative colitis should be treated with atorvastatin or another statin.”

Khatri said if these findings are validated in a prospective cohort, this will move close to changing patient care.