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Published in: Arthritis Research & Therapy 1/2021

Open Access 01-12-2021 | Statins | Research article

Risk of rheumatoid arthritis diagnosis in statin users in a large nationwide US study

Authors: Madeline N. Peterson, Hayley J. Dykhoff, Cynthia S. Crowson, John M. Davis III, Lindsey R. Sangaralingham, Elena Myasoedova

Published in: Arthritis Research & Therapy | Issue 1/2021

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Abstract

Objective

To evaluate the association between statin use and the risk of developing rheumatoid arthritis (RA) in a large, US case-control study.

Methods

Using the OptumLabs Data Warehouse, RA cases were identified as patients aged ≥18 years with ≥2 RA diagnoses between January 1, 2010 and June 30, 2019 and ≥1 prescription fills for methotrexate within 1 year of the first RA diagnosis. The first RA diagnosis was the index date. Cases were matched 1:1 to controls on age, sex, region, year of index date, and length of baseline coverage. Statin users were defined by having ≥2 statin prescription fills at least 90 days pre-index. Patients identified as statin users were further classified by statin user status (current or former), statin use duration, and intensity of statin exposure. Odds ratios for RA risk with statin use were estimated using logistic regression.

Results

16,363 RA cases and 16,363 matched controls were identified. Among RA cases, 5509 (33.7%) patients were statin users compared to 5164 (31.6%) of the controls. Statin users had a slightly increased risk of RA compared to non-users (OR 1.12, 95% CI 1.06–1.18), and former statin users had an increased RA risk compared to current users (OR 1.21, 95% CI 1.13–1.28). However, risk was eliminated following adjustment for hyperlipidemia. The risk estimates for statin use duration and intensity did not reach significance.

Conclusion

This study demonstrates no significant increase in the risk of developing RA for statin users compared to non-users after adjustment for hyperlipidemia in addition to other relevant confounders. However, more information from prospective studies would be necessary to further understand this relationship.
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Literature
3.
go back to reference Sever PS, Dahlöf B, Poulter NR, Wedel H, Beevers G, Caulfield M, et al. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet. 2003;361(9364):1149–58. https://doi.org/10.1016/S0140-6736(03)12948-0.CrossRefPubMed Sever PS, Dahlöf B, Poulter NR, Wedel H, Beevers G, Caulfield M, et al. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet. 2003;361(9364):1149–58. https://​doi.​org/​10.​1016/​S0140-6736(03)12948-0.CrossRefPubMed
5.
go back to reference Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med. 1998;339(19):1349-57. https://doi.org/10.1056/NEJM199811053391902. Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med. 1998;339(19):1349-57. https://​doi.​org/​10.​1056/​NEJM199811053391​902.
6.
11.
go back to reference Lv S, Liu Y, Zou Z, Li F, Zhao S, Shi R, et al. The impact of statins therapy on disease activity and inflammatory factor in patients with rheumatoid arthritis: a meta-analysis. Clin Exp Rheumatol. 2015;33(1):69–76.PubMed Lv S, Liu Y, Zou Z, Li F, Zhao S, Shi R, et al. The impact of statins therapy on disease activity and inflammatory factor in patients with rheumatoid arthritis: a meta-analysis. Clin Exp Rheumatol. 2015;33(1):69–76.PubMed
12.
go back to reference Okamoto H, Koizumi K, Kamitsuji S, Inoue E, Hara M, Tomatsu T, et al. Beneficial action of statins in patients with rheumatoid arthritis in a large observational cohort. J Rheumatol. 2007;34(5):964–8.PubMed Okamoto H, Koizumi K, Kamitsuji S, Inoue E, Hara M, Tomatsu T, et al. Beneficial action of statins in patients with rheumatoid arthritis in a large observational cohort. J Rheumatol. 2007;34(5):964–8.PubMed
15.
go back to reference Mowla K, Rajai E, Ghorbani A, Dargahi-Malamir M, Bahadoram M, Mohammadi S. Effect of atorvastatin on the disease activity and severity of rheumatoid arthritis: double-blind randomized controlled trial. J Clin Diagn Res. 2016;10(5):Oc32–6.PubMedPubMedCentral Mowla K, Rajai E, Ghorbani A, Dargahi-Malamir M, Bahadoram M, Mohammadi S. Effect of atorvastatin on the disease activity and severity of rheumatoid arthritis: double-blind randomized controlled trial. J Clin Diagn Res. 2016;10(5):Oc32–6.PubMedPubMedCentral
27.
go back to reference OptumLabs. OptumLabs Data Warehouse (OLDW) Descriptions and Citation. Cambridge, MA 2019. OptumLabs. OptumLabs Data Warehouse (OLDW) Descriptions and Citation. Cambridge, MA 2019.
28.
go back to reference Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2019;73(24):3168–209. https://doi.org/10.1016/j.jacc.2018.11.002.CrossRefPubMed Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2019;73(24):3168–209. https://​doi.​org/​10.​1016/​j.​jacc.​2018.​11.​002.CrossRefPubMed
34.
go back to reference Noël B. Statins and lupus erythematosus. Rheumatology. 2004;43(3):397–8.CrossRef Noël B. Statins and lupus erythematosus. Rheumatology. 2004;43(3):397–8.CrossRef
38.
go back to reference Blanco-Colio LM, Villa A, Ortego M, Hernández-Presa MA, Pascual A, Plaza JJ, et al. 3-Hydroxy-3-methyl-glutaryl coenzyme A reductase inhibitors, atorvastatin and simvastatin, induce apoptosis of vascular smooth muscle cells by downregulation of Bcl-2 expression and Rho A prenylation. Atherosclerosis. 2002;161(1):17–26. https://doi.org/10.1016/S0021-9150(01)00613-X.CrossRefPubMed Blanco-Colio LM, Villa A, Ortego M, Hernández-Presa MA, Pascual A, Plaza JJ, et al. 3-Hydroxy-3-methyl-glutaryl coenzyme A reductase inhibitors, atorvastatin and simvastatin, induce apoptosis of vascular smooth muscle cells by downregulation of Bcl-2 expression and Rho A prenylation. Atherosclerosis. 2002;161(1):17–26. https://​doi.​org/​10.​1016/​S0021-9150(01)00613-X.CrossRefPubMed
50.
go back to reference Symmons DP, Bankhead CR, Harrison BJ, Brennan P, Barrett EM, Scott DG, et al. Blood transfusion, smoking, and obesity as risk factors for the development of rheumatoid arthritis: results from a primary care-based incident case-control study in Norfolk, England. Arthritis Rheum. 1997;40(11):1955–61. https://doi.org/10.1002/art.1780401106.CrossRefPubMed Symmons DP, Bankhead CR, Harrison BJ, Brennan P, Barrett EM, Scott DG, et al. Blood transfusion, smoking, and obesity as risk factors for the development of rheumatoid arthritis: results from a primary care-based incident case-control study in Norfolk, England. Arthritis Rheum. 1997;40(11):1955–61. https://​doi.​org/​10.​1002/​art.​1780401106.CrossRefPubMed
51.
go back to reference Di Giuseppe D, Bottai M, Askling J, Wolk A. Physical activity and risk of rheumatoid arthritis in women: a population-based prospective study. Arthritis Res Ther. 2015;17(1):1–7.CrossRef Di Giuseppe D, Bottai M, Askling J, Wolk A. Physical activity and risk of rheumatoid arthritis in women: a population-based prospective study. Arthritis Res Ther. 2015;17(1):1–7.CrossRef
Metadata
Title
Risk of rheumatoid arthritis diagnosis in statin users in a large nationwide US study
Authors
Madeline N. Peterson
Hayley J. Dykhoff
Cynthia S. Crowson
John M. Davis III
Lindsey R. Sangaralingham
Elena Myasoedova
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 1/2021
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/s13075-021-02617-5

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