Association between statin use and clinical course, microbiologic characteristics, and long-term outcome of early Lyme borreliosis. A post hoc analysis of prospective clinical trials of adult patients with erythema migrans

PLoS One. 2021 Dec 16;16(12):e0261194. doi: 10.1371/journal.pone.0261194. eCollection 2021.

Abstract

Background: Statins were shown to inhibit borrelial growth in vitro and promote clearance of spirochetes in a murine model of Lyme borreliosis (LB). We investigated the impact of statin use in patients with early LB.

Methods: In this post-hoc analysis, the association between statin use and clinical and microbiologic characteristics was investigated in 1520 adult patients with early LB manifesting as erythema migrans (EM), enrolled prospectively in several clinical trials between June 2006 and October 2019 at a single-center university hospital. Patients were assessed at enrollment and followed for 12 months.

Results: Statin users were older than patients not using statins, but statin use was not associated with Borrelia seropositivity rate, Borrelia skin culture positivity rate, or disease severity as assessed by erythema size or the presence of LB-associated symptoms. The time to resolution of EM was comparable in both groups. The odds for incomplete recovery decreased with time from enrollment, were higher in women, in patients with multiple EM, and in those reporting LB-associated symptoms at enrollment, but were unaffected by statin use.

Conclusion: Statin use was not associated with clinical and microbiologic characteristics or long-term outcome in early LB.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Borrelia burgdorferi Group / drug effects*
  • Borrelia burgdorferi Group / isolation & purification
  • Erythema Chronicum Migrans / drug therapy
  • Erythema Chronicum Migrans / epidemiology
  • Erythema Chronicum Migrans / microbiology
  • Erythema Chronicum Migrans / pathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage*
  • Lyme Disease / drug therapy
  • Lyme Disease / epidemiology
  • Lyme Disease / microbiology
  • Lyme Disease / pathology*
  • Male
  • Middle Aged
  • Prospective Studies
  • Skin / drug effects
  • Skin / microbiology
  • Skin / pathology*

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors

Grants and funding

This research was supported by the Slovenian Research Agency [grant number P3-0296, J3-6788]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.