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. 2010 Jan;69(1):85-94.
doi: 10.1111/j.1365-2125.2009.03560.x.

Is there an anti-inflammatory effect of statins in rheumatoid arthritis? Analysis of a large routinely collected claims database

Sara Lodi  1 , Stephen J W Evans, Peter Egger, James Carpenter
Affiliations

Is there an anti-inflammatory effect of statins in rheumatoid arthritis? Analysis of a large routinely collected claims database

Sara Lodi et al. Br J Clin Pharmacol. 2010 Jan.

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.

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Figures

Figure 1
Figure 1
Pictorial representation of assessment of statin exposure in (a) sub-cohort I [non-users of oral steroids (OS) at rheumatoid arthritis (RA) index date] and (b) sub-cohort II (users of OS at RA index date). Current statin exposure is defined as a minimum exposure to 30 days of uninterrupted statin therapy
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References

    1. 4S investigators. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S) Lancet. 1994;344:1383–9. - PubMed
    1. Shepherd J, Cobbe SM, Ford I, Isle CG, Lorimer AR, MacFarlane PW, McKillop JH, Packard CJ. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary Prevention Study Group. N Engl J Med. 1995;333:1301–8. - PubMed
    1. Sacks FM, Pfeffer MA, Moye LA, Rouleau JL, Rutherford JD, Cole TG, Brown L, Warnica W, Arnold MO, Wun CC, Davis BR, Braunwald E. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol and Recurrent Events Trial investigators. N Engl J Med. 1996;335:1001–9. - PubMed
    1. The 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;339:1349–57. - PubMed
    1. Downs JR, Clearfield M, Weis S, Whitney E, Shapiro DR, Beere PA, Langendorfer A, Stein EA, Kruyer W, Gotto AM. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. Air Force/Texas Coronary Atherosclerosis Prevention Study. JAMA. 1998;279:1615–22. - PubMed

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