{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T10:49:13Z","timestamp":1791802153294,"version":"4.3.4"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Data from Asian cohorts on whether statin therapy affects amyotrophic lateral sclerosis (ALS) progression are limited. We examined whether statin exposure was associated with ALS disease duration or tracheostomy\u2010free survival in a multiethnic Asian ALS cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from patients diagnosed with ALS between 2012 and 2025 were retrospectively reviewed. Patients were categorized as \u201cever\u201d or \u201cnever\u201d statin users for primary analyses, and as \u201cnever,\u201d \u201cformer,\u201d or \u201ccurrent\u201d users at diagnosis for additional analyses. Disease duration was defined as time from symptom onset to death, and tracheostomy\u2010free survival as time from symptom onset to tracheostomy or death without tracheostomy. Kaplan\u2013Meier and Cox regression analyses evaluated associations between statin exposure and both outcomes. Additional analyses examined statin discontinuation after diagnosis using time\u2010varying exposures. Sensitivity analyses excluded post\u2010diagnosis imitators and applied 30\u2010, 90\u2010, and 180\u2010day lags.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 103 ALS patients, 27 (26.2%) had ever received statins. Statin exposure was not significantly associated with disease duration (hazard ratio [HR]: 1.42, 95% CI: 0.64\u20133.14,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.387) or tracheostomy\u2010free survival (HR: 1.04, 95% CI: 0.50\u20132.18,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.913). Post\u2010diagnosis statin discontinuation was associated with shorter survival in a time\u2010varying analysis (HR: 6.52, 95% CI: 1.48\u201328.74,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013), although this finding was hypothesis\u2010generating. Sensitivity analyses did not show statistically significant associations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In this multiethnic Asian ALS cohort, statin exposure was not significantly associated with disease duration or tracheostomy\u2010free survival. These findings add to the evidence that statins do not need to be discontinued due to ALS diagnosis. Larger studies are needed to define this association.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.70427","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T10:26:47Z","timestamp":1791800807000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Statin Exposure and Survival Outcomes in Amyotrophic Lateral Sclerosis in an Asian Cohort"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9902-7225","authenticated-orcid":false,"given":"Anushika","family":"Raheja","sequence":"first","affiliation":[{"name":"Department of Neurology National Neuroscience Institute (Singapore General Hospital Campus)  Singapore Singapore"},{"name":"Department of Neurology National Neuroscience Institute (Tan Tock Seng Campus)  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8347-1163","authenticated-orcid":false,"given":"Kexin","family":"Ang","sequence":"additional","affiliation":[{"name":"Department of Neurology National Neuroscience Institute (Tan Tock Seng Campus)  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2709-1972","authenticated-orcid":false,"given":"Bernett","family":"Lee","sequence":"additional","affiliation":[{"name":"Singapore Immunology Network (SIgN) Agency for Science, Technology and Research (A*STAR)  Singapore Singapore"},{"name":"Centre for Biomedical Informatics, Lee Kong Chian School of Medicine Nanyang Technological University  Singapore Singapore"},{"name":"A*STAR Infectious Diseases Labs Agency for Science, Technology and Research A*STAR  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6473-4375","authenticated-orcid":false,"given":"Seyed Ehsan","family":"Saffari","sequence":"additional","affiliation":[{"name":"Department of Neurology National Neuroscience Institute (Singapore General Hospital Campus)  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eng King","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Neurology National Neuroscience Institute (Singapore General Hospital Campus)  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5445-5965","authenticated-orcid":false,"given":"Crystal Jing Jing","family":"Yeo","sequence":"additional","affiliation":[{"name":"Department of Neurology National Neuroscience Institute (Tan Tock Seng Campus)  Singapore Singapore"},{"name":"Institute of Molecular and Cell Biology (IMCB) Agency for Science, Technology and Research (A*STAR)  Singapore Singapore"},{"name":"School of Medicine, Medical Sciences and Nutrition University of Aberdeen  Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12015"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000285080.70324.27"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000625"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.17925\/EE.2022.18.2.89"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.70095"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264\u2010017\u20100620\u20104"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwac054"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/17482960802031092"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.51697"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.110.936278"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000214221"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000001384"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11051359"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol\u20102021\u2010003256"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0022\u2010510x(99)00210\u20105"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/21678421.2023.2285443"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010147\u20108\u2010200710160\u201000010"},{"key":"e_1_2_13_19_1","unstructured":"UpToDate 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