Statin use does not significantly increase rheumatoid arthritis risk
There is no significant increase in the risk for rheumatoid arthritis in patients who use statins, compared with nonusers, according to data published in Arthritis Research & Therapy.
“There is growing data on the pleiotropic effects of statins, including modifying effects on immune and inflammatory response,” Elena Myasoedova, MD, PhD, of the Mayo Clinic, in Rochester, Minnesota, told Healio Rheumatology. “Existing studies — largely from the European populations — produced conflicting results on the association of statin use and the risk of RA development: Increased risk, decreased risk, no association. Statins are widely used, thus it is important to clarify their effects for the risk of autoimmune disease, such as RA.”
To examine the link between statin use and RA, Myasoedova and colleagues conducted a case-control study using the OptumLabs Data Warehouse, a large administrative database of de-identified health information on commercially insured and Medicare Advantage beneficiaries. Data included medical and pharmacy claims, laboratory results and enrollment records. For their study, the researchers identified 16,363 adults with at least two RA diagnoses between Jan. 1, 2010, and June 30, 2019, as well as at least one methotrexate prescription filled within 1 year of the first diagnosis. The day of the first RA diagnosis acted as the index date.
These patients were matched 1:1 to 16,363 control individuals based on age, sex, region, year of index date and the length of baseline coverage. Statin use was defined as having at least two statin prescriptions filled at least 90 days prior to the index date. Individuals deemed statin users were additionally classified by current or former use status, duration of use and intensity of exposure. The researchers used logistic regression to estimate ORs for RA risk with statin use.
According to the researchers, 33.7% patients with RA were statin users, compared with 31.6% of the control individuals. Statin users demonstrated a slightly increased risk for RA compared with non-users (OR = 1.12; 95% CI, 1.06-1.18), while former users had an increased RA risk compared with current users (OR = 1.21; 95% CI, 1.13-1.28). However, this risk was eliminated after adjusting for hyperlipidemia. The risk estimates for statin use duration and intensity failed to reach significance.
“Ours is the first large nationwide study of the association between statin use and risk of RA in the United States,” Myasoedova said. “We found no increase or decrease in risk of RA in statin users versus non-users after adjusting for multiple important confounders, particularly hyperlipidemia. This finding is reassuring in that it does not indicate or support any change to the current clinical recommendations for prescribing statins.”