The use of statins decreased the risk for all-cause mortality in patients with rheumatoid arthritis (RA) compared with patients with RA who did not use statin medications, according to the results of a study published in the Journal of Managed Care + Specialty Pharmacy.
There is evidence that statin use lowers mortality rates in patients with RA due to the cardioprotective effects of these medications. This study used propensity matching to examine the association between statin use and mortality in a large sample of patients with RA in the US.
Using the University of Utah Enterprise Data Warehouse, this retrospective study identified a cohort of patients who were diagnosed with RA from January 2007 to December 2015 and initiated statin therapy after their RA diagnosis. Patients were assigned an index date, which was a random date within an annual block in which the patient started statin use. Comparison cohorts were propensity score matched within the same annual block. The primary outcome was all-cause mortality.
A total of 19,614 individuals, 2089 of whom used statins, were included in the study. Propensity matching yielded 1833 nonstatin and statin pairs with similar baseline characteristics of age, sex, comorbidities, and medication use. After adjusting for residual confounding, statin users had a 28% lower risk for mortality vs nonstatin users (hazard ratio [HR]=0.72, 95% CI, 0.56-0.91; P =.008).
Limitations of the study included the potential for misclassification of diagnoses, the inability to adjust for all confounding factors, exclusion of individuals with missing data from the analyses that may have resulted in bias, limited generalizability because of low use of disease-modifying antirheumatic drugs and nonsteroidal anti-inflammatory drugs in the study cohort, and the possibility that cause-specific mortality might have been a better endpoint.
The researchers concluded, “We believe that these results provide strong rationale for conducting bigger observational or interventional studies in order to validate the findings. In addition, decision makers and providers should consider these results and support integration of statin use in current clinical guidelines for delivering better quality health care to RA patients.”
Chhibber A, Hansen S, Biskupiak J. Statin use and mortality in rheumatoid arthritis: an incident user cohort study. J Manag Care Spec Pharm. 2021;27(3):296-305. doi:10.18553/jmcp.2021.27.3.296