{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:30:19Z","timestamp":1791199819119,"version":"4.2.0"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T00:00:00Z","timestamp":1615248000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T00:00:00Z","timestamp":1615248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100004339","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J GEN INTERN MED"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Statins are effective lipid-lowering drugs for the prevention of cardiovascular disease, but muscular adverse events can limit their use. Hydrophilic statins (pravastatin, rosuvastatin) may cause less muscular events than lipophilic statins (e.g. simvastatin, atorvastatin) due to lower passive diffusion into muscle cells.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>To compare the risk of muscular events between statins at comparable lipid-lowering doses and to evaluate if hydrophilic statins are associated with a lower muscular risk than lipophilic statins.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Design\/Setting<\/jats:title>\n                <jats:p>Propensity score-matched cohort study using data from the United Kingdom-based Clinical Practice Research Datalink (CPRD) GOLD.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Patients<\/jats:title>\n                <jats:p>New statin users. Cohort 1: pravastatin 20-40 mg (hydrophilic) vs simvastatin 10-20 mg (lipophilic), cohort 2: rosuvastatin 5-40 mg (hydrophilic) vs atorvastatin 10-80 mg (lipophilic), and cohort 3: simvastatin 40-80 mg vs atorvastatin 10-20 mg.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Main Measures<\/jats:title>\n                <jats:p>The outcome was a first record of a muscular event (myopathy, myalgia, myositis, rhabdomyolysis) during a maximum follow-up of 1 year.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Results<\/jats:title>\n                <jats:p>The propensity score-matched cohorts consisted of 1) 9,703, 2) 7,032, and 3) 37,743 pairs of statin users. Comparing the risk of muscular events between low-intensity pravastatin vs low-intensity simvastatin yielded a HR of 0.86 (95% CI 0.64-1.16). In the comparison of moderate- to high-intensity rosuvastatin vs equivalent doses of atorvastatin, we observed a HR of 1.17 (95% CI 0.88-1.56). Moderate- to high-intensity simvastatin was associated with a HR of 1.33 (95% CI 1.16-1.53), when compared with atorvastatin at equivalent doses.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Limitations<\/jats:title>\n                <jats:p>We could not conduct other pairwise comparisons of statins due to small sample size. In the absence of a uniform definition on the comparability of statin doses, the applied dose ratios may not fully match with all literature sources.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our results do not suggest a systematically lower risk of muscular events for hydrophilic statins when compared to lipophilic statins at comparable lipid-lowering doses.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11606-021-06651-6","type":"journal-article","created":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T18:02:27Z","timestamp":1615312947000},"page":"2639-2647","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["The Risk of Muscular Events Among New Users of Hydrophilic and Lipophilic Statins: an Observational Cohort Study"],"prefix":"10.1007","volume":"36","author":[{"given":"Alexandra M.","family":"Mueller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelia","family":"Liakoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Burkard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan S.","family":"Jick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Kr\u00e4henb\u00fchl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph R.","family":"Meier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Spoendlin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,9]]},"reference":[{"key":"6651_CR1","unstructured":"National Institute for Health and Care Excellence. Clinical guideline CG181 - Cardiovascular disease: risk assessment and reduction, including lipid modification. https:\/\/www.nice.org.uk\/guidance\/cg181. Published 2014. Accessed November 25, 2019."},{"key":"6651_CR2","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1093\/eurheartj\/ehz455","volume":"41","author":"F Mach","year":"2020","unstructured":"Mach F, Baigent C, Catapano AL, et al. 2019 ESC\/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41:111-188.","journal-title":"Eur Heart J."},{"key":"6651_CR3","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1093\/eurheartj\/ehv043","volume":"36","author":"ES Stroes","year":"2015","unstructured":"Stroes ES, Thompson PD, Corsini A, et al. Statin-associated muscle symptoms: impact on statin therapy - European Atherosclerosis Society Consensus Panel Statement on Assessment, Aetiology and Management, Eur Heart J. 2015;36:1012-1022.","journal-title":"Eur Heart J."},{"key":"6651_CR4","doi-asserted-by":"publisher","first-page":"858","DOI":"10.7326\/0003-4819-150-12-200906160-00009","volume":"150","author":"TR Joy","year":"2009","unstructured":"Joy TR, Hegele RA. Narrative review: statin-related myopathy. Ann Intern Med. 2009;150:858-868.","journal-title":"Ann Intern Med."},{"key":"6651_CR5","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1097\/BOR.0b013e32833f0fc7","volume":"22","author":"AL Mammen","year":"2010","unstructured":"Mammen AL, Amato AA. Statin myopathy: A review of recent progress. Curr Opin Rheumatol. 2010;22:644-650.","journal-title":"Curr Opin Rheumatol."},{"key":"6651_CR6","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1177\/2047487314550804","volume":"23","author":"J Auer","year":"2016","unstructured":"Auer J, Sinzinger H, Franklin B, Berent R. Muscle- and skeletal-related side-effects of statins: tip of the iceberg?. Eur J Prev Cardiol. 2016;23:88-110.","journal-title":"Eur J Prev Cardiol."},{"key":"6651_CR7","doi-asserted-by":"publisher","first-page":"171","DOI":"10.2165\/11319380-000000000-00000","volume":"33","author":"YS Chatzizisis","year":"2010","unstructured":"Chatzizisis YS, Koskinas KC, Misirli G, Vaklavas C, Hatzitolios A, Giannoglou GD. Risk factors and drug interactions predisposing to statin-induced myopathy: implications for risk assessment, prevention and treatment. Drug Saf. 2010;33:171-187.","journal-title":"Drug Saf."},{"issue":"Suppl 2","key":"6651_CR8","doi-asserted-by":"publisher","first-page":"S325","DOI":"10.2337\/dcS13-2038","volume":"36","author":"R Bitzur","year":"2013","unstructured":"Bitzur R, Cohen H, Kamari Y, Harats D. Intolerance to statins: Mechanisms and management. Diabetes Care. 2013;36 Suppl 2:S325-S330.","journal-title":"Diabetes Care."},{"key":"6651_CR9","doi-asserted-by":"publisher","first-page":"22","DOI":"10.3390\/jcm9010022","volume":"9","author":"RM Turner","year":"2019","unstructured":"Turner RM, Pirmohamed M. Statin-Related Myotoxicity: A Comprehensive Review of Pharmacokinetic, Pharmacogenomic and Muscle Components, J Clin Med. 2019;9:22.","journal-title":"J Clin Med."},{"key":"6651_CR10","first-page":"1841","volume":"2015","author":"A Bonifacio","year":"1853","unstructured":"Bonifacio A, Sanvee GM, Bouitbir J, Kr\u00e4henb\u00fchl S. The AKT\/mTOR signaling pathway plays a key role in statin-induced myotoxicity. Biochim Biophys Acta. 2015;1853:1841-1849.","journal-title":"Biochim Biophys Acta."},{"key":"6651_CR11","doi-asserted-by":"publisher","first-page":"e154","DOI":"10.1016\/j.atherosclerosis.2006.12.001","volume":"194","author":"LA Leiter","year":"2007","unstructured":"Leiter LA, Rosenson RS, Stein E, et al. Efficacy and safety of rosuvastatin 40 mg versus atorvastatin 80 mg in high-risk patients with hypercholesterolemia: Results of the POLARIS study. Atherosclerosis. 2007;194:e154-e164.","journal-title":"Atherosclerosis."},{"key":"6651_CR12","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1111\/j.1368-5031.2005.00708.x","volume":"59","author":"AF Bots","year":"2005","unstructured":"Bots AF, Kastelein JJ. Discovery Netherlands Investigators. Achieving lipid goals in real life: The Dutch DISCOVERY study. Int J Clin Pract. 2005;59:1387-1394.","journal-title":"Int J Clin Pract."},{"key":"6651_CR13","doi-asserted-by":"publisher","first-page":"204209861985401","DOI":"10.1177\/2042098619854010","volume":"10","author":"RE Ghosh","year":"2019","unstructured":"Ghosh RE, Crellin E, Beatty S, Donegan K, Myles P, Williams R. How Clinical Practice Research Datalink data are used to support pharmacovigilance. Ther Adv Drug Saf. 2019;10:2042098619854010.","journal-title":"Ther Adv Drug Saf."},{"key":"6651_CR14","first-page":"241","volume-title":"Pharmacoepidemiology","author":"BL Strom","year":"2020","unstructured":"Strom BL, Kimmel SE, Hennessy S. Electronic Health Record Databases. In: Pharmacoepidemiology. Sixth edit. Hoboken, NJ: Wiley-Blackwell; 2020:241-289.","edition":"Sixth edit"},{"key":"6651_CR15","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1093\/ije\/dyv098","volume":"44","author":"E Herrett","year":"2015","unstructured":"Herrett E, Gallagher AM, Bhaskaran K, et al. Data Resource Profile: Clinical Practice Research Datalink (CPRD). Int J Epidemiol. 2015;44:827-836.","journal-title":"Int J Epidemiol."},{"key":"6651_CR16","unstructured":"Electronic medicines compendium. Crestor 10 mg film-coated tablets - Summary of Product Characteristics. https:\/\/www.medicines.org.uk\/emc\/product\/7559\/smpc. Accessed February 11, 2020."},{"key":"6651_CR17","doi-asserted-by":"publisher","first-page":"i3305","DOI":"10.1136\/bmj.i3305","volume":"353","author":"Y Vinogradova","year":"2016","unstructured":"Vinogradova Y, Coupland C, Brindle P, Hippisley-Cox J. Discontinuation and restarting in patients on statin treatment: Prospective open cohort study using a primary care database. BMJ. 2016;353:i3305.","journal-title":"BMJ."},{"key":"6651_CR18","doi-asserted-by":"publisher","first-page":"S35","DOI":"10.1016\/j.cjca.2016.01.003","volume":"32","author":"GB Mancini","year":"2016","unstructured":"Mancini GB, Baker S, Bergeron J, et al. Diagnosis, Prevention, and Management of Statin Adverse Effects and Intolerance: Canadian Consensus Working Group Update (2016). Can J Cardiol. 2016;32:S35-S65.","journal-title":"Can J Cardiol."},{"key":"6651_CR19","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1136\/jnnp.2008.168294","volume":"80","author":"MC Dalakas","year":"2009","unstructured":"Dalakas MC. Toxic and drug-induced myopathies. J Neurol Neurosurg Psychiatry. 2009;80:832-838.","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"6651_CR20","first-page":"748","volume":"112","author":"U Laufs","year":"2015","unstructured":"Laufs U, Scharnagl H, Halle M, Windler E, Endres M, M\u00e4rz W. Treatment Options for Statin-Associated Muscle Symptoms. Dtsch Arztebl Int. 2015;112:748-755.","journal-title":"Dtsch Arztebl Int."},{"key":"6651_CR21","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1093\/ageing\/afw039","volume":"45","author":"A Clegg","year":"2016","unstructured":"Clegg A, Bates C, Young J, et al. Development and validation of an electronic frailty index using routine primary care electronic health record data. Age Ageing. 2016;45:353-360.","journal-title":"Age Ageing."},{"key":"6651_CR22","first-page":"e8940","volume":"10","author":"E Patorno","year":"2013","unstructured":"Patorno E, Grotta A, Bellocco R, Schneeweiss S. Propensity score methodology for confounding control in health care utilization databases. Epidemiol Biostat Public Health. 2013;10:e8940.","journal-title":"Epidemiol Biostat Public Health."},{"key":"6651_CR23","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1080\/00273171.2011.568786","volume":"46","author":"PC Austin","year":"2011","unstructured":"Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav Res. 2011;46:399-424.","journal-title":"Multivariate Behav Res."},{"key":"6651_CR24","unstructured":"Department of Health and Social Care. National Service Framework for Coronary Heart Disease. Modern Standards and Service Models. London: Department of Health and Social Care; 2000. https:\/\/www.gov.uk\/government\/publications\/quality-standards-for-coronary-heart-disease-care."},{"key":"6651_CR25","doi-asserted-by":"publisher","first-page":"1246","DOI":"10.1136\/bmj.39554.624086.AD","volume":"336","author":"A Cooper","year":"2008","unstructured":"Cooper A, O\u2019Flynn N. Guideline Development Group. Risk assessment and lipid modification for primary and secondary prevention of cardiovascular disease: Summary of NICE guidance. BMJ. 2008;336:1246-1248.","journal-title":"BMJ."},{"key":"6651_CR26","doi-asserted-by":"publisher","first-page":"e90325","DOI":"10.1371\/journal.pone.0090325","volume":"9","author":"A Helin-Salmivaara","year":"2014","unstructured":"Helin-Salmivaara A, Lavikainen P, Aarnio E, Huupponen R, Korhonen MJ. Sequential cohort design applying propensity score matching to analyze the comparative effectiveness of atorvastatin and simvastatin in preventing cardiovascular events. PLoS One. 2014;9:e90325.","journal-title":"PLoS One."},{"key":"6651_CR27","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1023\/A:1020363010465","volume":"2","author":"DB Rubin","year":"2001","unstructured":"Rubin DB. Using propensity scores to help design observational studies: Application to the tobacco litigation. Health Services & Outcomes Research Methodology. 2001;2:169-188.","journal-title":"Health Services & Outcomes Research Methodology."},{"key":"6651_CR28","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.1080\/03610910902859574","volume":"38","author":"PC Austin","year":"2009","unstructured":"Austin PC. Using the standardized difference to compare the prevalence of a binary variable between two groups in observational research. Commun Stat Simul Comput. 2009;38:1228-1234.","journal-title":"Commun Stat Simul Comput."},{"key":"6651_CR29","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/j.ejim.2012.01.004","volume":"23","author":"S Sathasivam","year":"2012","unstructured":"Sathasivam S. Statin induced myotoxicity. Eur J Intern Med. 2012;23:317-324.","journal-title":"Eur J Intern Med."},{"key":"6651_CR30","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1002\/pds.3199","volume":"21","author":"CG Rowan","year":"2012","unstructured":"Rowan CG, Brunelli SM, Munson J, et al. Clinical importance of the drug interaction between statins and CYP3A4 inhibitors: a retrospective cohort study in The Health Improvement Network. Pharmacoepidemiol Drug Saf. 2012;21:494-506.","journal-title":"Pharmacoepidemiol Drug Saf."},{"key":"6651_CR31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5114\/aoms.2015.49807","volume":"11","author":"M Banach","year":"2015","unstructured":"Banach M, Rizzo M, Toth PP, et al. Statin intolerance - An attempt at a unified definition. Position paper from an International Lipid Expert Panel. Arch Med Sci. 2015;11:1-23.","journal-title":"Arch Med Sci."},{"key":"6651_CR32","doi-asserted-by":"publisher","first-page":"1654","DOI":"10.1016\/j.amjcard.2008.08.014","volume":"102","author":"J Wlodarczyk","year":"2008","unstructured":"Wlodarczyk J, Sullivan D, Smith M. Comparison of benefits and risks of rosuvastatin versus atorvastatin from a meta-analysis of head-to-head randomized controlled trials. Am J Cardiol. 2008;102:1654-1662.","journal-title":"Am J Cardiol."},{"key":"6651_CR33","doi-asserted-by":"publisher","first-page":"104201","DOI":"10.1016\/j.phrs.2019.03.010","volume":"154","author":"J Bouitbir","year":"2020","unstructured":"Bouitbir J, Sanvee GM, Panajatovic MV, Singh F, Kr\u00e4henb\u00fchl S. Mechanisms of statin-associated skeletal muscle-associated symptoms. Pharmacol Res. 2020;154:104201.","journal-title":"Pharmacol Res."},{"key":"6651_CR34","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1038\/clpt.2009.197","volume":"87","author":"M Niemi","year":"2010","unstructured":"Niemi M. Transporter pharmacogenetics and statin toxicity. Clin Pharmacol Ther. 2010;87:130-133.","journal-title":"Clin Pharmacol Ther."},{"key":"6651_CR35","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1111\/bcp.12360","volume":"78","author":"D Mo\u00dfhammer","year":"2014","unstructured":"Mo\u00dfhammer D, Schaeffeler E, Schwab M, M\u00f6rike K. Mechanisms and assessment of statin-related muscular adverse effects. Br J Clin Pharmacol. 2014;78:454-466.","journal-title":"Br J Clin Pharmacol."},{"key":"6651_CR36","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1007\/s10557-005-5686-z","volume":"19","author":"E Bruckert","year":"2005","unstructured":"Bruckert E, Hayem G, Dejager S, Yau C, B\u00e9gaud B. Mild to moderate muscular symptoms with high-dosage statin therapy in hyperlipidemic patients - The PRIMO study. Cardiovasc Drugs Ther. 2005;19:403-414.","journal-title":"Cardiovasc Drugs Ther."},{"key":"6651_CR37","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1007\/s00228-016-2105-2","volume":"72","author":"I Skilving","year":"2016","unstructured":"Skilving I, Eriksson M, Rane A, Ovesj\u00f6 ML. Statin-induced myopathy in a usual care setting\u2014a prospective observational study of gender differences. Eur J Clin Pharmacol. 2016;72:1171-1176.","journal-title":"Eur J Clin Pharmacol."},{"key":"6651_CR38","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1007\/s40471-014-0027-z","volume":"1","author":"MJ Funk","year":"2014","unstructured":"Funk MJ, Landi SN. Misclassification in administrative claims data: quantifying the impact on treatment effect estimates. Curr Epidemiol Rep. 2014;1:175-185.","journal-title":"Curr Epidemiol Rep."},{"key":"6651_CR39","doi-asserted-by":"publisher","first-page":"1601","DOI":"10.1016\/S0195-668X(03)00347-6","volume":"24","author":"G De Backer","year":"2003","unstructured":"De Backer G, Ambrosioni E, Borch-Johnsen K, et al. European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J. 2003;24:1601-1610.","journal-title":"Eur Heart J."},{"issue":"Suppl 5","key":"6651_CR40","first-page":"v1","volume":"91","author":"British Cardiac Society, British Hypertension Society, Diabetes UK, HEART UK, Primary Care Cardiovascular Society, Stroke Association","year":"2005","unstructured":"British Cardiac Society, British Hypertension Society, Diabetes UK, HEART UK, Primary Care Cardiovascular Society, Stroke Association. JBS 2: Joint British Societies\u2019 guidelines on prevention of cardiovascular disease in clinical practice. Heart. 2005;91 Suppl 5:v1-v52.","journal-title":"Heart"}],"container-title":["Journal of General Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-021-06651-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11606-021-06651-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-021-06651-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T00:46:27Z","timestamp":1630025187000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11606-021-06651-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,9]]},"references-count":40,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["6651"],"URL":"https:\/\/doi.org\/10.1007\/s11606-021-06651-6","relation":{},"ISSN":["0884-8734","1525-1497"],"issn-type":[{"value":"0884-8734","type":"print"},{"value":"1525-1497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,9]]},"assertion":[{"value":"29 July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 March 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Alexandra M. Mueller, Evangelia Liakoni, and Stephan Kr\u00e4henb\u00fchl report grants from Sanofi, during the conduct of the study. Cornelia Schneider, Theresa Burkard, Susan S. Jick, Christoph R. Meier, and Julia Spoendlin declare to have no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}},{"value":"This study is based on data from the Clinical Practice Research Datalink obtained under license from the UK Medicines and Healthcare products Regulatory Agency. The data is provided by patients and collected by the NHS as part of their care and support. The interpretation and conclusions contained in this study are those of the authors alone.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Additional Statement"}}]}}