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Front. Pharmacol. | doi: 10.3389/fphar.2018.00225

Simvastatin therapy for drug repositioning to reduce the risk of prostate cancer mortality in patients with hyperlipidemia

Yu-An Chen1, Ying-Ju Lin1, Cheng-Li Lin2, Hua-Shan Wu3, Hui-Ying Hsu1, Yu-Chen Sun4,  Chih-Ho Lai5* and  Chia-Hung Kao2
  • 1China Medical University, Taiwan
  • 2China Medical University Hospital, Taiwan
  • 3Asia University, Taiwan
  • 4Chang Gung Memorial Hospital, Taiwan
  • 5Chang Gung University, Taiwan

Prostate cancer (PCa) is one of the most commonly diagnosed cancers in the western world, and the mortality rate from PCa in Asia has been increasing recently. Statins are potent inhibitors of 3-hydroxy-3-methyl glutaryl coenzyme A (HMG-CoA) reductase and are commonly used for treating hyperlipidemia, with beneficial effects for cardiovascular disease and they also exhibit anti-cancer activity. However, the protective effects of statins against PCa are controversial. In this study, we investigated the effect of two types of statins (simvastatin and lovastatin) and the mortality rate of PCa patients by using the Taiwan National Health Insurance Research Database (NHIRD). A total of 15,264 PCa patients with hyperlipidemia records and medical claims from the Registry of Catastrophic Illness were enrolled. The patients were divided into two cohorts based on their statin use before the diagnosis of PCa: statin users (n = 1,827) and non-statin users (n = 1,826). The results showed that patients who used statins exhibited a significantly reduced risk of mortality from PCa (adjusted hazard ratio [HR] = 0.84, 95% CI = 0.73–0.97). Analysis of the cumulative defined daily dose (DDD) indicated that patients who were prescribed simvastatin ≥180 DDD had a dramatically decreased risk of death from PCa (adjusted HR  = 0.63; 95% CI  =  0.51–0.77). This population-based cohort study demonstrated that statin use significantly decreased the mortality of PCa patients, and that this risk was inversely associated with the cumulative DDD of simvastatin therapy. The results of this study revealed that statins may be used for drug repositioning and in the development of a feasible approach to prevent death from PCa.

Keywords: prostate cancer, Hyperlipidemia, HMG-CoA reductase, statin, cohort study

Received: 27 Oct 2017; Accepted: 27 Feb 2018.

Edited by:

Yuhei Nishimura, Mie University Graduate School of Medicine, Japan

Reviewed by:

William B. Grant, Sunlight Nutrition and Health Research Center, United States
Muhammad Imran Qadir, Bahauddin Zakariya University, Pakistan
CHIA-YANG LI, Kaohsiung Medical University, Taiwan  

Copyright: © 2018 Chen, Lin, Lin, Wu, Hsu, Sun, Lai and Kao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Chih-Ho Lai, Chang Gung University, Guishan District, Taiwan,