Is There an Anti-inflammatory Effect of Statins in Rheumatoid Arthritis? Analysis of a Large Routinely Collected Claims Database

Overview

Journal Br J Clin Pharmacol

Specialty Pharmacology

Date 2010 Jan 19

PMID 20078616

Citations 12

Authors

Sara Lodi

Stephen J W Evans

Peter Egger

James Carpenter

Affiliations

Soon will be listed here.

Abstract

What Is Already Known About This Subject: * The increasing evidence of the anti-inflammatory action of statins has stimulated interest in whether these might be beneficial in disease management of rheumatoid arthritis (RA), a chronic diseases characterized by high levels of inflammation. * The TARA trial (McCarey 2004) suggested a significant reduction in disease activity outcomes in RA patients randomized to atorvastatin compared with those assigned to the placebo harm. * However, as the signal reported by the trial was small, more evidence is needed.

What This Paper Adds: * We investigated the possible anti-inflammatory effect of statins in a cohort of RA patients using a large health insurance claims database. * To our knowledge, this is the largest study ever conducted on the anti-inflammatory effects of statins. * Our data do not show any beneficial effect of statins in reducing disease inflammation in RA patients.

Aim: To investigate the possible anti-inflammatory effect of statins in a cohort of rheumatoid arthritis (RA) patients.

Methods: We conducted a cohort study consisting of all patients with at least one claim for RA using LifeLink, a health insurance claims database. Initiation and cessation of oral steroid (OS) therapy were treated as surrogate for inflammatory flare-up and controlled inflammation, respectively. We split the RA patients into two sub-cohorts based on whether they were using OS within a specified time window of the RA index date (first recorded claim for RA in the database). Cox proportional hazard models were used to evaluate the association between time-varying exposure to any statins and (i) initiation of OS therapy in the non-users of OS at RA index date and (ii) cessation of OS therapy in the users of OS at RA index date controlling for potential confounders.

Results: We found 31 451 non-users of OS at RA index date and 6026 users of OS within the time window at RA index date. The results on both sub-cohorts were both consistent with no association of statin exposure with the risk of initiation/cessation of OS: the hazard ratio (HR) of initiating OS therapy was 0.96 (95% confidence interval 0.9, 1.01) in the sub-cohort of non-users and the HR of cessation of OS therapy was 0.95 (0.87, 1.05) in the sub-cohort of users of OS therapy at RA diagnosis.

Conclusions: These data do not show any beneficial effect of statins in reducing disease inflammation in RA patients.

Citing Articles

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Free Fatty Acids in Bone Pathophysiology of Rheumatic Diseases.

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Effect of Atorvastatin on the Disease Activity and Severity of Rheumatoid Arthritis: Double-Blind Randomized Controlled Trial.

Mowla K, Rajai E, Ghorbani A, Dargahi-Malamir M, Bahadoram M, Mohammadi S J Clin Diagn Res. 2016; 10(5):OC32-6.

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Association of the use of statins with disease activity and functional status in Puerto Ricans with rheumatoid arthritis.

Villafradez-Diaz M, Santiago-Casas Y, Nieves-Plaza M, Morales M, Rodriguez V, Rios G P R Health Sci J. 2014; 33(1):3-8.

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