Pattern of risks of rheumatoid arthritis among patients using statins: A cohort study with the clinical practice research datalink

We examined the association between statin use and the risk of rheumatoid arthritis (RA), with special focus on describing the patterns of risks of RA during statin exposure in a large population-based cohort in the United Kingdom. In the Clinical Practice Research Datalink, patients aged ≥40 years...

Full description

Saved in:
Bibliographic Details
Published in:PloS one 2018-02, Vol.13 (2), p.e0193297
Main Authors: de Jong, Hilda J I, Cohen Tervaert, Jan Willem, Lalmohamed, Arief, de Vries, Frank, Vandebriel, Rob J, van Loveren, Henk, Klungel, Olaf H, van Staa, Tjeerd P
Format: Article
Language:English
Subjects:
Arthritis
Atherosclerosis
Biology and Life Sciences
Cardiovascular diseases
Clinical trials
Cohort analysis
Complications and side effects
Cytokines
Development and progression
Diabetes
Disease susceptibility
Dosage and administration
Exposure
Family medical history
Health risk assessment
Health risks
Hormone replacement therapy
Hyperlipidemia
Lymphocytes
Medicine and Health Sciences
Patients
Pharmaceutical sciences
Pharmacology
Pharmacy
Population studies
Practice research
Public health
Research and Analysis Methods
Rheumatoid arthritis
Risk analysis
Risk factors
Statins
Studies
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We examined the association between statin use and the risk of rheumatoid arthritis (RA), with special focus on describing the patterns of risks of RA during statin exposure in a large population-based cohort in the United Kingdom. In the Clinical Practice Research Datalink, patients aged ≥40 years with at least one prescription of statins (1995-2009) were selected, and matched by age (+/-5 years), sex, practice and date of first prescription of statins to non-users. The follow-up period of statin use was divided into periods of current, recent and past exposure, with patients moving between these three exposure categories over time. Time-dependent Cox models were used to derive hazard ratios (HRs) of RA, adjusted for disease history and previous drug use. The study population included 1,023,240 patients, of whom 511,620 were statin users. No associations were found between RA and current (HRadj,1.06;99%CI:0.88-1.27) or past statin users (HRadj,1.18;99%CI:0.88-1.57). However, in patients who currently used statins, hazard rates were increased shortly after the first prescription of statins and then gradually decreased to baseline level. The risk of developing RA was increased in recent statin users, as compared to non-users (HRadj,1.39;99%CI:1.01-1.90). The risk of RA is substantially increased in the first year after the start of statins and then diminishes to baseline level. These findings may suggest that statins might accelerate disease onset in patients susceptible to develop RA, but in other patients, statins are probably safe and well tolerated, even after prolonged use. Alternatively, we cannot rule out that confounding by cardiovascular risk factors and ascertainment bias may have influenced the findings.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0193297