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 (Hoboken). 2013 Oct;65(10):1592-9. doi: 10.1002/acr.22029.

Abstract

Objective: To examine lipid profiles among statin-naive patients with rheumatoid arthritis (RA) and those without RA before and after the initiation of statins.

Methods: 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.

Results: 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.

Conclusion: 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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid / blood
  • Arthritis, Rheumatoid / epidemiology*
  • Blood Sedimentation
  • Case-Control Studies
  • Cholesterol / blood
  • Cholesterol, LDL / blood
  • Dyslipidemias / blood
  • Dyslipidemias / drug therapy*
  • Dyslipidemias / epidemiology
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Incidence
  • Likelihood Functions
  • Linear Models
  • Lipids / blood*
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Minnesota / epidemiology
  • Odds Ratio
  • Risk Factors
  • Time Factors
  • Treatment Outcome

Substances

  • Cholesterol, LDL
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Lipids
  • Cholesterol