Statin use and clinical osteoarthritis in the general population: a longitudinal study

J Gen Intern Med. 2013 Jul;28(7):943-9. doi: 10.1007/s11606-013-2382-8. Epub 2013 Mar 8.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Osteoarthritis / diagnosis
  • Osteoarthritis / drug therapy*
  • Osteoarthritis / epidemiology*
  • Population Surveillance / methods*
  • Treatment Outcome


  • Hydroxymethylglutaryl-CoA Reductase Inhibitors