Statin use may protect against uveitis

This review of medical records from a managed care network shows that the odds of developing uveitis were about 50% less for statin users compared to patients not taking this class of medications.

Because statins have a relatively benign side-effect profile compared to systemic immunosuppressant therapies often required to treat more severe uveitis, the authors suggest that it may be reasonable to prescribe statins to patients with uveitis to help moderate disease severity.

To evaluate the association between statin use and uveitis, the authors analyzed medical records from a managed care network, comparing 108 uveitis cases with 2 randomly selected control groups; 1 from the general plan membership and 1 from the plan’s ophthalmology clinic.

Data showed that the odds of a statin user developing uveitis were 48% less than for a nonstatin user from the health plan's general population (P = 0.03), after adjusting for age, sex, race and autoimmune disease.

The authors write that a number of immunomodulatory and anti-inflammatory mechanisms could explain these findings. Statins have been shown to reduce levels of key inflammatory cytokines, such as interleukins 6 and 8 and TNF-alpha, as well as C-reactive protein.Additionally, this class of medications has been shown to decrease interactions between leukocytes and endothelial cells via the intercellular adhesion molecule-1 (ICAM-1) pathway. This can prevent leukocyte migration across the blood-retinal barrier, thus decreasing intraocular inflammation.

Similarly, statins can help strengthen the blood-retinal barrier by decreasing the formation of oxygen free radicals and increasing levels of nitric oxide. Both of these mechanisms have been shown to stabilize endothelial cells in the vasculature.