Research Article: Persistence with Statins and Onset of Rheumatoid Arthritis: A Population-Based Cohort Study

Date Published: September 7, 2010

Publisher: Public Library of Science

Author(s): Gabriel Chodick, Howard Amital, Yoav Shalem, Ehud Kokia, Anthony D. Heymann, Avi Porath, Varda Shalev, Tom W. J. Huizinga

Abstract: In a retrospective cohort study, Gabriel Chodick and colleagues find a significant association between persistence with statin therapy and reduced risk of developing rheumatoid arthritis, but only a modest decrease in risk of osteoarthritis.

Partial Text: Rheumatoid arthritis (RA) is a leading cause of disability that often reduces patients’ quality of life and impairs their ability to work [1]. Prevalence estimates of RA worldwide indicate that the prevalence of RA range between 2.0 to 10.7 per 1,000 adults, based on the 1987 revised American College of Rheumatology (ACR) criteria [2].

The median number of health plan enrollees during the study period was more than 1.6 million, with persons aged 18 y or above accounting for 66% of the population. After applying the inclusion and exclusion criteria, a total of 211,627 individuals for the RA analysis and 193,770 individuals for the OA analysis were identified as being newly treated with statin agents during the study period. During the study follow-up period 11,692 individuals died and 3,343 left MHS.

The present study demonstrates a significant negative association between persistence with statin therapy and RA onset, particularly in adult patients who began treatment at a relatively young age and with high efficacy statins. Our results agree with a previous nested case-control study [26] in hyperlipidemia patients, which compared 313 RA patients and 1,252 matched controls. In that analysis, the adjusted OR for development of RA in subjects taking statins compared to the reference group was 0.59 (95% CI 0.37–0.96). Similar to the present study, it was also found that patients receiving high efficacy statins (atorvastatin) had a lower odds ratio for contracting RA, although the difference did not reach statistical significance.



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