Key result
Metabolic and bariatric surgery linked to ~71% higher statin discontinuation and lower initiation at two years.
Why the study?
Metabolic and bariatric surgery is the most durable treatment of obesity and can reduce statin use, but comparative statin use trajectories post-surgery were unclear.
Does metabolic and bariatric surgery reduce the need for statin therapy in adults compared to matched controls?
Cohort (n=32,718)
Does metabolic and bariatric surgery reduce the need for statin therapy in adults compared to matched controls?
Absolute Event Rate: 60.4% vs 35.4%
Metabolic and bariatric surgery significantly increases the discontinuation of statins among baseline users and decreases the initiation of statins among statin-naive individuals, highlighting its role in managing dyslipidemia.
MBS-linked statin changes may signal lipid improvement; hypothesis-generating and should not yet change practice.
BACKGROUND: Metabolic and bariatric surgery (MBS) is the most durable treatment of obesity and can reduce statin use. OBJECTIVE: We compare statin use trajectories in patients with and without MBS. METHODS: were identified using a U.S. employer-based retrospective claims database. Individuals who had MBS were matched 1:1 with those who did not. Trajectories of statin use were stratified by statin use in the year before the index date and examined in the 2 years after the index date. SETTING: University Hospital. RESULTS: Sixteen thousand three hundred fifty-nine adults who had MBS and 16,359 matched adults who did not were analyzed. In both groups, 19.4% filled a statin prescription in the year before the index date. In the 2 years after the index date, individuals using statins remained similar at 20% (year 1) and 19% (year 2) among those who didn't have an MBS and decreased to 12.5% (year 1) and 9.3% (year 2) in the MBS cohort. Among baseline statin users, 35.4% of non-MBS and 60.4% of the MBS cohort stopped using statins within 2 years of the index date. Among statin naïve individuals at baseline, 9.6% of the non-MBS cohort started using statins within 2 years of the index date, compared to 2.6% of those who had MBS. CONCLUSIONS: MBS results in a significant discontinuation of statins among baseline users, and significantly decreased the initiation of medications among individuals who were statin naive at baseline. This demonstrates that MBS is both a treatment and preventative measure for dyslipidemia.
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Caballero et al. (2024) conducted a cohort in Obesity (n=32,718). Metabolic and bariatric surgery vs. No metabolic and bariatric surgery was evaluated on Statin discontinuation within 2 years among baseline users. Metabolic and bariatric surgery significantly increased statin discontinuation among baseline users (60.4% vs 35.4%) and decreased initiation among statin-naive individuals (2.6% vs 9.6%) at 2 years.
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