Statins May Cut Seizure Risk Post-Status Epilepticus

TOPLINEPatients who used statins after a first episode of status epilepticus (SE) had a lower long-term risk of developing remote unprovoked seizures (RS) than those who did not use statins.METHODOLOGYResearchers conducted an observational study to assess whether the use of statins was associated with the long-term risk for RS after a first episode of incident SE.They included 314 patients (mean age, 70 years; 63% female individuals) with a first onset of SE who were consecutively admitted to a hospital in Italy between 2015 and 2023 and were also included in the Modena Status Epilepticus Registry.Overall, 86 patients received statins at hospital discharge, of whom 68 had already been taking statins before the episode of SE, whereas 18 received them during the first week of hospitalisation.Patients were grouped as statin users — comprising those taking statins at SE onset or starting the therapy within a week of admission — or non-users who did not receive statin therapy and were also discharged without statins in their treatment plans. Most statin-treated patients received atorvastatin (80%), with a median dose of 20 mg.The main outcome was the occurrence of RS, defined according to the International League Against Epilepsy criteria as an unprovoked seizure occurring beyond 7 days from the acute index event. Patients were followed up for a mean duration of 31.5 months.TAKEAWAYOverall, 21% of patients developed RS; the cumulative probability was 16%, 23%, 28%, 29%, and 31% at 1, 2, 3, 4, and 5 years after SE, respectively, with no cases of first relapse occurring beyond 5 years after the first SE event.Patients experienced their first episode of RS at a median of 6.9 months after the index SE episode; 63% of RS occurred within 1 year after SE.Patients who received statins had a 52% lower long-term risk for RS than those who did not receive statins (adjusted hazard ratio, 0.48; P = .021).Those who experienced SE due to progressive central nervous system disorders showed a 2.01-fold increased long-term risk for seizure recurrence (P = .043); the risk rose up to 3.74-fold for motor SE with evolution into non-convulsive SE (P < .001).IN PRACTICE"[The study] findings argue against confounding by indication as the primary explanation for our results and support the association between statin therapy and reduced risk of RS after SE," the authors wrote."[O]ur findings should be interpreted as hypothesis-generating rather than as evidence of a causal, antiepileptogenic effect of statins," they added.SOURCEThis study was led by Niccolò Orlandi, Neurophysiology Unit, Neuroscience Department, Azienda Ospedaliera-Universitaria, Modena, Italy. It was published online on September 15, 2026, in Epilepsia.LIMITATIONSThe observational study design precluded definitive conclusions about causality. Data on neurophysiologic and neuroimaging biomarkers were not included. The statin-exposed cohort included both patients who were already receiving statins before SE and those who started treatment afterward, potentially representing different biological and clinical scenarios.DISCLOSURESNo funding information was provided for this study. One author declared receiving research grant support from the Ministry of Health and personal compensation as a scientific advisory board member for several pharmaceutical companies. Another author reported receiving speaker or consultancy fees from Angelini.This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.