One of the benefits of large medical record databases is the availability of a vast amount of information related to medication use and patient health status. For example, a research team from Massachusetts General Hospital recently used The Health Improvement Network (THIN) to analyze potential associations between statins and survival in patients with rheumatoid arthritis (RA). The researchers discovered that statin use may benefit individuals with RA.
“Statin initiation is associated with lower risk of mortality among patients with RA,” wrote lead author Dr. Sara R. Schoenfeld, in the article, “Statin Use and Mortality in Rheumatoid Arthritis: A General Population-Based Cohort Study,” which was published in the journal Annals of the Rheumatic Diseases. “The magnitude of association is similar to that seen in previous randomized trials among the general population.”
To conduct the study, the researchers looked through 10.2 million patients on record in THIN to find a sample of patients aged 20 years and older who have RA and use at least one disease-modifying antirheumatic drug (DMARD). They then noted the use of statins during the patient’s course of treatment and created a model to describe a potential association between mortality and statin initiation. A propensity score was required in order to prevent confounding variables from skewing results of the model.
Comparing statin initiators and statin non-initiators after propensity score matching, there were fewer deaths in the statin initiator group than the statin non-initiator group (432 vs. 513). Quantified in another way, the incidence of death was 32.6 per 1000 person-years in the statin initiator group and 40.6 deaths per 1000 person-years in the statin non-initiator group. Statin initiators were 21% less likely to die than statin non-initiators in the follow-up period.
It is thought that statins may benefit RA patients because the drugs have lipid-lowering and anti-inflammatory properties. Since RA is a chronic disease characterized by inflammation, RA patients’ inflammation may be reduced upon statin initiation. For example, one previous study identified that statins combined with DMARD treatment enhance RA patients’ Disease Activity Scores, swollen joint counts, and inflammatory marker profiles.
Typically given to patients with cardiovascular disease, statins may have benefits for RA patients. It appears that starting statin therapy while also taking DMARD treatments lowers mortality in afflicted RA patients.