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Statin use has been associated with both favorable and poor prognoses. We assessed whether statin use affects ALS survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We linked four Norwegian health surveys (1972\u20132003) with mandatory national registries to obtain information on premorbid health, ALS diagnosis, and death. Using the Norwegian Prescribed Drug Registry, we identified participants who had dispensed statins pre\u2010 and post\u2010diagnosis. We first compared pre\u2010diagnosis statin discontinuation rates between ALS patients and matched controls. Flexible parametric models were then fitted to estimate the relationship between statin use and survival time in ALS, using restricted mean survival time and hazard ratio (HR) as effect measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 524 patients (43% female) with ALS were included. Mean time from ALS diagnosis to death or end of study was 2.0 (SD 2.1) years. A substantial proportion of statin users (21%) discontinued statins during the year leading up to diagnosis. This group was characterized by poorer ALS prognosis compared to those adhering to statins and were included as statin users in our analysis. After adjusting for sex, age, birth year, riluzole use and premorbid smoking status, body mass index, and total cholesterol levels, statin use was not associated with ALS survival. The estimated mean survival difference comparing statin users to non\u2010users was 0.74 (95% CI \u22125.98 to 7.47) months, corresponding to a HR of 0.97 (95% CI 0.77\u20131.23).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Statin use was not associated with ALS survival, suggesting that statins should not routinely be discontinued in ALS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.70095","type":"journal-article","created":{"date-parts":[[2025,3,8]],"date-time":"2025-03-08T05:51:52Z","timestamp":1741413112000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Statin Use and Amyotrophic Lateral Sclerosis Survival: A Population\u2010Based Cohort Study"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4995-7722","authenticated-orcid":false,"given":"Anders Myhre","family":"Vaage","sequence":"first","affiliation":[{"name":"Department of Neurology Akershus University Hospital  L\u00f8renskog Norway"},{"name":"Institute of Clinical Medicine University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2529-5664","authenticated-orcid":false,"given":"Trygve","family":"Holm\u00f8y","sequence":"additional","affiliation":[{"name":"Department of Neurology Akershus University Hospital  L\u00f8renskog Norway"},{"name":"Institute of Clinical Medicine University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0369-9393","authenticated-orcid":false,"given":"Jesper","family":"Dahl","sequence":"additional","affiliation":[{"name":"Department of Infection Control and Vaccines Norwegian Institute of Public Health  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hein","family":"Stigum","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Global Health University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3262-8260","authenticated-orcid":false,"given":"Haakon E.","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Global Health University of Oslo  Oslo Norway"},{"name":"Department of Physical Health and Ageing Norwegian Institute of Public Health  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4765-0636","authenticated-orcid":false,"given":"Ola","family":"Nakken","sequence":"additional","affiliation":[{"name":"Department of Neurology Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(22)01272\u20107"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/17482960802566824"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1212\/nxg.0000000000000398"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/17482960701656940"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcad211"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24936"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/21678421.2020.1832119"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000009322"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3233\/jad\u2010170660"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415\u2010023\u201011630\u20104"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000201657"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415\u2010024\u201012665\u2010x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awae270"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1987.03400240064025"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/2047487313480435"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41569\u2010018\u20100098\u20105"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/21678421.2018.1511731"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11051359"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/ede.0000000000001384"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25048"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41419\u2010021\u201003669\u2010w"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/17482960802031092"},{"key":"e_1_2_9_24_1","unstructured":"R. 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