Prescription database analyses indicates that the asthma medicine montelukast might protect against dementia: a hypothesis to be verified

Abstract Background It has recently been shown that the leukotriene receptor antagonist montelukast rejuvenates aged brains in rats. The question is whether this commonly used, systemic, anti-asthmatic medicine has a similar effect in humans? Results We approached this issue by doing statistical analyses based on the Norwegian Prescription Database. The Database lists all prescription-based medications in Norway, but not drugs given to people who are in hospitals or nursing homes. The question asked was whether users of montelukast, compared to users of inhalation asthma medicine, live longer, and are less likely to develop dementia. A small, non-significant protective effect on the use of dementia medicine became significant when adjusting for other prescriptions (based on the notion that montelukast users on average are less healthy). A possible protective effect was substantiated by looking at the lack of prescriptions as a proxy for dementia-related residency in nursing homes, and the risk of death. Conclusions The present results suggest that montelukast may alleviate the cognitive decline associated with human aging. However, further data, preferably based on controlled clinical trials, are required

Prevalence and characteristics of patients with low levels of low-density lipoprotein cholesterol in northern Denmark: a descriptive study

Sigrun Alba Johannesdottir Schmidt,1 Uffe Heide-Jørgensen,1 Angelika D Manthripragada,2 Vera Ehrenstein1 1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Center for Observational Research, Amgen Inc., Thousand Oaks, CA, USA Background: With the emergence of new lipid-lowering therapies, more patients are expected to achieve substantial lowering of low-density lipoprotein cholesterol (LDL-C). However, there are limited data examining the clinical experience of patients with low (<1.3 mmol/L) or very low (<0.65 mmol/L) levels of LDL-C. To provide information on patients with low LDL-C, we identified and characterized persons with low LDL-C using data from Danish medical databases. Methods: Using a population-based clinical laboratory database, we identified adults with at least one LDL-C measurement in northern Denmark between 1998 and 2011 (population approximately 1.5 million persons). Based on the lowest measurement during the study period, we divided patients into groups with low (<1.3 mmol/L), moderate (1.3–3.3 mmol/L), or high (>3.3 mmol/L) LDL-C. We described their demographic characteristics, entire comorbidity history, and 90-day prescription history prior to the lowest LDL-C value measured. Finally, we further restricted the analysis to individuals with very low LDL-C (<0.65 mmol/L). Results: Among 765,503 persons with an LDL-C measurement, 23% had high LDL-C, 73% had moderate LDL-C, and 4.8% had low LDL-C. In the latter group, 9.6% (0.46% of total) had very low LDL-C. Compared with the moderate and high LDL-C categories, the low LDL-C group included more males and older persons with a higher prevalence of cardiovascular disease, diabetes, chronic pulmonary disease, ulcer disease, and obesity, as measured by hospital diagnoses or relevant prescription drugs for these diseases. Cancer and use of psychotropic drugs were also more prevalent. These patterns of distribution became even more pronounced when restricting to individuals with very low LDL-C. Conclusion: Using Danish medical databases, we identified a cohort of patients with low LDL-C and found that cohort members differed from patients with higher LDL-C levels. These differences may be explained by various factors, including prescribing patterns of lipid-lowering therapies. Keywords: cross-sectional study, hyperlipidemia, registries, statin