01 Nov High Intensity Statins Linked To Lower Risk of Rheumatoid Arthritis
MedicalResearch.com Interview with:
Dr. Marie Hudson
Marie Hudson, MD MPH FRCPC
Jewish General Hospital and Lady David Research Institute
Montreal, QC
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Statins are widely used to treat hypercholesterolemia. In addition to their effect on cholesterol levels, statins also attenuate inflammation and have immunomodulatory properties. Whether this translates into meaningful differences in health outcomes, though, remains uncertain. We therefore undertook this study to determine whether people exposed to high doses of statins were at a lower risk of developing rheumatoid arthritis compared to those at lower doses. We studied a large population-based cohort of over half a million people exposed to statins for the first time and followed them on average for 3 years.
We found that those exposed to the highest intensity statin quintile had a 33% lower risk of developing rheumatoid arthritis compared to those in the lowest intensity quintile (adjusted HR 0.77; 95% CI: 0.63-0.95). We conducted several additional secondary analyses that all pointed in the same direction and suggested that statins reduce the risk of rheumatoid arthritis.
MedicalResearch.com: What should readers take away from your report?
Response: Our study provides convincing data that statins have the potential to modulate the immune system in a clinically meaningful way and possibly delay or even prevent the onset of rheumatoid arthritis. If anything, for the time being, our results inform dosing decisions of clinicians who need to initiate cholesterol-lowering therapy in individuals at high risk of rheumatoid arthritis.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Increasingly, we are recognizing that rheumatoid arthritis has a pre-clinical phase. The detection of biomarkers during this phase and recent therapeutic advances suggest that it may be possible to identify and treat persons at high risk, before the onset of clinical disease, to prevent rheumatoid arthritis. Given the results of our study, it is conceivable that statins could be used to prevent, or at least delay, the onset of rheumatoid arthritis. However, this would have to be tested in a randomized controlled trial.
MedicalResearch.com: Is there anything else you would like to add?
Response: There are several studies currently investigating various drugs to prevent rheumatoid arthritis, including rituximab and abatacept. However, these drugs are not without serious side effects and are costly. It is unclear how high-risk individuals and their health care professionals would make decisions whether to take such medications, or less toxic or costly alternatives such as statins, to prevent a disease that they may in fact never develop. Integrating the various stakeholders in the decision-making process will be an important step before undertaking screening and preventive strategies at the population level.
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Last Updated on November 1, 2016 by Marie Benz MD FAAD