TORONTO — Statin use was associated with a reduced risk of knee or hip replacement in individuals with rheumatoid arthritis but not osteoarthritis, according to findings of a large cohort study presented here.
“There is a growing interest in studying these potential disease modifying agents for progression of osteoarthritis and disease activity in rheumatoid arthritis,” Jie Wei, MD, of the department of orthopedics at Xiangya Hospital in China, told attendees at the OARSI 2019 World Congress on Osteoarthritis. “But the beneficial effects remain controversial.”
To investigate potential associations between statins and risk of joint replacement, Wei and colleagues conducted a prospective cohort study, which included data from 17 million patient records from 718 practitioners spread across 13 regions in the UK, representing almost 26% of the UK population. She reported on the final data set of 178,467 matched pairs. The cohort was 52% women with a mean age of 62 years.
Eligible participants were aged 40 years or older. Data for the period ranging from Jan. 1, 1989 through July 31, 2017 underwent analysis.
“Exposure of statin users was defined as people who were ever prescribed a statin two or more times during the study period,” Wei said. “The date of the first prescription date was considered the index date.”
The matched control group was comprised of individuals who had never been prescribed statins.
“Statins were categorized as low intensity, medium intensity, and high intensity according to their lipid lowering potency,” Wei said.
The primary outcome was at least one record of total or partial knee or hip joint replacement. The researchers further broke down outcomes into replacement due to OA or RA. Participants were followed from index date to first joint replacement. Covariates included age, gender, lifestyle factors such as smoking or drinking, OA or RA duration, comorbidities, and other medications used.
Wei reported that overall statin use was significantly associated with lower risk of joint replacement in patients with RA (HR = 0.77; 95% CI, 0.63-0.94). “There were no significant associations between statin use and osteoarthritis,” she said.
High-dose statins were associated with lower risk of any joint replacement (HR = 0.86), joint replacement due to OA (HR = 0.79), and joint replacement due to RA (HR = .1), according to Wei.
“Statins may reduce the risk of joint replacement, especially given at high strength, and in people with rheumatoid arthritis,” Wei concluded. —by Rob Volansky
Sarmanova A, et al. Abstract #77. Presented at: OARSI 2019 World Congress on Osteoarthritis; May 2-5; Toronto, Canada.
Disclosure: Wei reports no relevant financial disclosures.