Abstract: Cholesterol-Lowering Medication as a Risk Factor for ALS
Funding Agency: Muscular Dystrophy Association

Few studies have been conducted to identify environmental, medical and lifestyle risk factors for ALS. Using data from a recently completed epidemiologic study of ALS, we propose to address three specific aims: (i) to investigate whether the use of cholesterol-lowering drugs increases the risk of developing ALS, (ii) to determine whether the use of cholesterol-lowering medication is associated with the length of survival after diagnosis among individuals with ALS, and (iii) to determine if there is a relationship between cholesterol levels prior to disease onset and the risk of developing ALS, independent of the use of cholesterol lowering agents. To address these objectives, we propose to follow-up 166 men and women who were newly diagnosed with ALS during the years 1996-2000, as well as 389 age- and gender-matched control subjects. Baseline clinical and epidemiologic data on these subjects were obtained shortly after diagnosis as part of a large NIH-funded case-control study, and included detailed information on demographic factors, clinical features of ALS, environmental and lifestyle factors, and comorbid disorders. In order to determine whether cholesterol-lowering medications or cholesterol levels are associated with the development or progression of ALS, we propose to link already collected information on ALS patients and control subjects to their computerized pharmacy records containing information on the prescription of cholesterol-lowering medications and also to computerized laboratory database records containing information on lipid levels prior to diagnosis with ALS. We will collect information about related medical conditions from computerized databases and medical record abstraction, and will follow-up all ALS cases and controls to identify vital status as of 31 December 2004. Funding from the MDA has enabled us to conduct this study without invoking the large expense of initiating a new study. If cholesterol or cholesterol-lowering medications are shown to play a role in the etiology or prognosis of ALS, this will contribute to knowledge about the pathogenic mechanisms of motor neuron disease. With this knowledge, strategies could be developed to prevent the disease or to slow disease progression among affected individuals.

Investigators: Lorene Nelson, PhD 1 Stephen Van Den Eeden, PhD 2

Valerie McGuire, PhD 1 Caroline Tanner, MD, PhD 3

1 Division of Epidemiology, Stanford University School of Medicine, Stanford, CA

2 Division of Research, Kaiser Foundation Research Institute, Oakland, CA

3 The Parkinson’s Institute, Sunnyvale, CA