Statin Medications and Amyotrophic Lateral Sclerosis Incidence and Mortality

Marc G. Weisskopf, Joseph Levy, Aisha S. Dickerson, Sabrina Paganoni, Maya Leventer-Roberts

Research output: Contribution to journalArticlepeer-review


Studies of statins and amyotrophic lateral sclerosis (ALS) incidence and survival have had conflicting findings possibly related to difficulties with confounding by indication. We considered potency of statins used and duration of use to explore confounding by indication. Within the Clalit Health Services in Israel, we identified 948 ALS case patients from 2004 through 2017 and matched them with 1,000 control subjects each. Any statin use up to 3 years before ALS onset was not associated with ALS incidence but was associated with a reduced hazard ratio (HR) for death. Odds of ALS did not vary by statin potency, but use of only lower-potency statins was associated with longer survival (HR = 0.82, 95% CI: 0.68, 0.98), whereas the association with higher-potency statins was null compared with those case patients who did not use statins. However, duration of statin use appeared to account for these findings. Those who used statins only up to 3 years had longer survival (HR = 0.77, 95% CI: 0.61, 0.96) than did case patients who did not use statins, but those who used statins for >3 years did not. Although other explanations are possible, these findings could suggest a protective effect of statins on ALS survival that is partially masked by a worse prognosis from underlying reasons for taking statins that deserves further exploration.

Original languageEnglish (US)
Pages (from-to)1248-1257
Number of pages10
JournalAmerican journal of epidemiology
Issue number7
StatePublished - Jul 1 2022


  • amyotrophic lateral sclerosis
  • epidemiology
  • hydroxymethylglutaryl-CoA reductase inhibitors
  • incidence
  • survival

ASJC Scopus subject areas

  • Epidemiology


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