Atorvastatin Reduced Cardiovascular Events in Rheumatoid Arthritis

Data published in Arthritis & Rheumatology show that atorvastatin significantly reduced low-density lipoprotein (LDL) cholesterol in patients with rheumatoid arthritis (RA).

Researchers conducted the randomized double-blind placebo-controlled TRACE RA study to determine whether atorvastatin is superior to placebo for the primary prevention of cardiovascular (CV) events in patients with RA. The study included 3002 adults age >50 or with a duration of RA >10 years who were randomly assigned to receive atorvastatin 40 mg (n=1504) or placebo (n=1498). Mean patient age was 61 and median duration of follow-up was 2.51 years. The primary end point was a composite of CV death, myocardial infarction, stroke, transient ischemic attack, or any arterial revascularization. Secondary end points included plasma lipids and safety.

Results showed that 1.6% of patients receiving atorvastatin 40 mg experienced a CV event compared with 2.4% of patients receiving placebo (adjusted hazard ratio, 0.60; 95% CI, 0.32-1.15; P =.127).

Patients who received atorvastatin also had 0.77±0.04 mmol/L lower LDL cholesterol compared with placebo and C-reactive protein levels were significantly lower in patients who received atorvastatin (2.59 mg/L vs 3.60 mg/L; P <.0001). In addition, researchers found that CV event risk reduction per LDL cholesterol mmol/L reduction was 42%. Adverse events were similar in both the atorvastatin (19.8%) and placebo (19.5%) groups.

“In this potentially vulnerable population, atorvastatin was safe with no excess of reports of muscle pain or other significant symptoms among those allocated atorvastatin compared to placebo,” the researchers concluded.

Reference

Kitas GD, Nightingale P, Armitage J, Sattar N, Belch JJF, Symmons DPM; TRACE RA consortium. Trial of atorvastatin for the primary prevention of cardiovascular events in patients with rheumatoid arthritis (TRACE RA): A multicenter, randomized, placebo controlled trial [published online April 15, 2019]. Arthritis Rheumatol. doi:10.1002/art.40892