Do statins lower joint replacement risk related to OA and RA?

  • Sarmanova A & al.
  • Rheumatology (Oxford)
  • 25 Feb 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Statins may reduce the risk for joint replacement because of rheumatoid arthritis (RA) but not osteoarthritis (OA).
  • High-intensity statin was associated with a reduction in the risk of joint replacement because of RA and OA; this effect was more pronounced in RA.

Why this matters

  • Statins have shown potential benefits on the progression of OA and on disease activity in RA, but existing evidence shows conflicting results.

Study design

  • 178,467 statin users were matched with equal numbers of statin non-users using propensity-score matching.
  • Main outcomes: total or partial knee joint replacement (KJR) or hip joint replacement (HJR).
  • Funding: The National Natural Science Foundation of China.

Key results

  • Overall, statin use was not associated with reduced risk for KJR or HJR (HR, 0.99; 95% CI, 0.97-1.03).
  • In the sub-group analysis, statin users vs non-users were at a lower risk for joint replacement due to RA (HR, 0.77; 95% CI, 0.63-0.94) but not due to OA (HR, 0.97; 95% CI, 0.94-1.01).
  • Risk for HJR (HR, 0.98; 95% CI, 0.93-1.03) and KJR (HR, 1.00; 95% CI, 0.96-1.05) did not differ between statin users vs non-users.
  • Compared with statin non-users, high-intensity statin users were associated with a lower risk for any joint replacement (HR, 0.86; 95% CI, 0.75-0.98), joint replacement due to RA (HR, 0.10; 95%CI, 0.02-0.65) and OA (HR, 0.79; 95% CI, 0.68-0.92).

Limitations

  • Risk of confounding.