Statin Use and Clinical Osteoarthritis in the General Population: A Longitudinal Study

Kadam, U. T.; Blagojevic, M.; Belcher, J.

Abstract

BACKGROUND: One hypothesis has posited whether abnormal lipid metabolism might be a causal factor in the pathogenesis of osteoarthritis (OA). Routine statin use in clinical practice provides the basis for a natural experiment in testing this hypothesis. OBJECTIVE: To test the hypothesis that statins reduce the long-term occurrence of clinically defined OA. DESIGN: Cohort design with a 10-year follow-up. PARTICIPANTS: 16,609 adults cardiovascular disease cohorts aged 40 years and over from the UK General Practice Research Database with data available to 31 December 2006. INTERVENTION: Statins were summarised as annual mean daily dose and dose change over two-year time periods. MAIN MEASURES: Incident episode of clinically defined osteoarthritis was assessed within 2 years, and at 4-year and 10-year follow-up time periods, using Cox and discrete time survival analysis. Covariates included age, gender, deprivation, body mass index, cholesterol level, pain-modifying drug co-therapies, and duration and severity of cardiovascular disease. KEY RESULTS: Higher therapeutic dose of statin, with a treatment duration of at least 2 years was associated with a significant reduction in clinical OA compared to non-statin users in the follow-up time period. The estimated adjusted rate ratios were as follows: lowest statin dose quartile 1: 2.5 (95 % CI 2.3, 2.9); quartile 2: 1.3 (1.1, 1.5); quartile 3: 0.8 (0.7, 0.95); and highest statin dose quartile 4: 0.4 (0.3, 0.5). The largest statin dose increments were associated with significant reductions estimated at 18 % in OA outcome within 2 years and 40 % after 4 years, compared to non-statin users. CONCLUSIONS: This longitudinal study from a national clinical practice setting provides evidence that higher statin dose and larger statin dose increments were associated with a reduction in clinically defined OA outcome.

Citation

Kadam, U. T., Blagojevic, M., & Belcher, J. (2013). Statin Use and Clinical Osteoarthritis in the General Population: A Longitudinal Study. Journal of General Internal Medicine, 28(7), 943-949. https://doi.org/10.1007/s11606-013-2382-8

• Journal Article Type: Article
• Acceptance Date: Feb 1, 2013
• Online Publication Date: Mar 8, 2013
• Publication Date: 2013-07
• Publicly Available Date: May 26, 2023
• Journal: JOURNAL OF GENERAL INTERNAL MEDICINE
• Print ISSN: 0884-8734
• Electronic ISSN: 1525-1497
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 28
• Issue: 7
• Pages: 943-949
• DOI: https://doi.org/10.1007/s11606-013-2382-8
• Keywords: aged, 80 and over, cohort studies, female, follow-up studies, humans, hydroxymethylglutaryl-coa reductase inhibitors, longitudinal studies, male, middle aged, osteoarthritis, population surveillance, public aspects of medicine, treatment outcome
• Publisher URL: http://link.springer.com/article/10.1007%2Fs11606-013-2382-8