Statin use in patients with RA: CVD benefits outweigh risk of new onset diabetes

By Samar Mahmoud, MS
Published February 10, 2022

Key Takeaways

  • This large cohort study found that statin use was associated with a reduced risk of cardiovascular disease (CVD) and all-cause mortality in rheumatoid arthritis (RA) patients. 

  • CVD benefits observed in this study outweighed the slight increase in type 2 diabetes mellitus (T2DM) risk. 

  • Since statins are underutilized in patients with RA, these findings encourage healthcare providers to initiate statins in eligible RA patients while monitoring for onset of T2DM.

Due to chronic inflammation, RA patients are at increased risk of mortality, CVD, and T2DM. Statins, which are the most commonly utilized intervention to improve CVD outcomes in the general population, have also been shown to increase T2DM risk.

Why This Study Matters 

Our current understanding of the overall effects of statins is limited to the general population, with few studies assessing statin use in RA patients. However, given that RA patients are at increased risk of CVD, mortality, and T2DM, it is imperative to assess the risk/benefit ratio of statins in this population. To address this need, this study sought to evaluate CVD and all-cause death benefits and T2DM risk associated with statin use in RA patients.

Study Design 

Investigators included patients with RA from the UK Clinical Practice Research Datalink who were registered between 1989 and 2018. Investigators defined statin use as a first-time prescription of atorvastatin, fluvastatin, pravastatin, rosuvastatin, simvastatin, and/or cerivastatin.

Patients who initiated statins were matched to two non-users Patients were followed until the composite endpoint of myocardial infarction, stroke, hospitalization for heart failure, CVD-mortality, all-cause mortality, and incident T2DM was reached. 

Results and Conclusions

The study included 1768 statin users and 3528 non-users. Initiation of statins was associated with a 32% reduction in CVD (HR=0.68) and a 54% reduction in all-cause mortality (HR=0.46).

Given that all-cause mortality benefits exceeded CVD event reduction, the study’s authors concluded that this suggests that statins may exert additional effects beyond their lipid-lowering properties. Investigators observed a 33% increase in T2DM  (HR=1.33)in statin users. 

Related Research

Consider these findings from similar research studies:

  • Current statin use is associated with a 28% lower risk of death in RA patients (Source). 

  • Statin use in RA patients is associated with a reduced risk of new-onset acute coronary syndrome (Source)

Original Source 

Ozen G, Dell’Aniello S, Pedro S, Michaud K, Suissa S. Reduction of cardiovascular disease and mortality versus risk of new onset diabetes with statin use in patients with rheumatoid arthritis. Arthritis Care & Research. Published online February 4, 2022:acr.24866.

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