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Impact of Statin Use on Lipid Levels in Statin-Naive Patients With Rheumatoid Arthritis Versus Non–Rheumatoid Arthritis Subjects: Results From a Population-Based Study†
Article first published online: 24 SEP 2013
Copyright © 2013 by the American College of Rheumatology
Arthritis Care & Research
Volume 65, Issue 10, pages 1592–1599, October 2013
How to Cite
Myasoedova, E., Gabriel, S. E., Green, A. B., Matteson, E. L. and Crowson, C. S. (2013), Impact of Statin Use on Lipid Levels in Statin-Naive Patients With Rheumatoid Arthritis Versus Non–Rheumatoid Arthritis Subjects: Results From a Population-Based Study. Arthritis Care Res, 65: 1592–1599. doi: 10.1002/acr.22029
- Issue published online: 24 SEP 2013
- Article first published online: 24 SEP 2013
- Accepted manuscript online: 16 APR 2013 08:54AM EST
- Manuscript Accepted: 27 MAR 2013
- Manuscript Received: 26 OCT 2012
- NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases. Grant Number: R01-AR-46849
- National Institute on Aging. Grant Number: R01-AG-034676
To examine lipid profiles among statin-naive patients with rheumatoid arthritis (RA) and those without RA before and after the initiation of statins.
Information regarding lipid measures and statin use was gathered in a population-based incident cohort of patients with RA (1987 American College of Rheumatology criteria first met between January 1, 1988 and January 1, 2008) and in a cohort of non-RA subjects from the same underlying population. Only patients with no prior history of statin use were included.
The study included 161 patients with RA (mean age 56.3 years, 57% female) and 221 non-RA subjects (mean age 56.0 years, 66% female). Prior to the start of statins, the levels of total cholesterol and low-density lipoprotein (LDL) cholesterol were lower in the RA versus the non-RA cohort (P < 0.001 and P = 0.003, respectively). The absolute and percentage change in LDL cholesterol after at least 90 days of statin use tended to be smaller in the RA versus the non-RA cohort (P = 0.03 and P = 0.09, respectively). After at least 90 days of statin use, patients with RA were less likely to achieve therapeutic goals for LDL cholesterol than the non-RA subjects (P = 0.046). Increased erythrocyte sedimentation rate (ESR) at baseline (odds ratio 0.47, 95% confidence interval 0.26–0.85) was associated with lower likelihood of achieving therapeutic LDL goals.
Patients with RA had lower total cholesterol and LDL cholesterol levels before statin initiation and lower likelihood of achieving therapeutic LDL goals following statin use than the non-RA subjects. Some RA disease characteristics, in particular ESR at baseline, may have an adverse impact on achieving therapeutic LDL goals.