Statin use for primary prevention of cardiovascular disease reduces the risk of incident IBD: A population-based cohort study

Background and objectives: Beyond genetics, environmental factors may contribute to the rising incidence of inflammatory bowel disease (IBD). Statins, widely used for cardiovascular risk reduction, also have anti-inflammatory properties and have been hypothesized to reduce IBD risk, though data are limited. We prospectively assessed the association between statin use and risk of developing IBD among individuals eligible for statin therapy for primary prevention of cardiovascular disease. Methods: Using a prospective new user design within the Danish National Registries, we identified a nationwide cohort of individuals aged ≥40 years from 2008 to 2022 eligible for statin therapy for primary cardiovascular prevention. Statin users were matched 1:5 to nonusers on age, sex, calendar year, and cardiovascular risk factors. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for incident IBD. Results: We identified 110,961 statin users and 554,805 matched nonusers. Statin use was associated with a reduced risk of IBD (aHR 0.84, 95% CI 0.72–0.97), with subgroup analyses showing similar reductions for Crohn's disease (aHR 0.84, 95% CI 0.65–1.09) and ulcerative colitis (aHR 0.83, 95% CI 0.69–1.00). This corresponds to a number needed to treat of 2881 to prevent one additional IBD case over 5 years of statin treatment. Findings remained consistent when censoring individuals at statin discontinuation. Conclusion: In this nationwide prospective study, statin use among individuals eligible for primary cardiovascular prevention was associated with a lower risk of developing IBD. These findings suggest a potential additional benefit of statins and support further research into their role in IBD prevention.