Issue: May 2012
April 13, 2012
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Ceasing statin therapy puts patients with rheumatoid arthritis at increased risk for death

Issue: May 2012
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Patients with rheumatoid arthritis who permanently discontinue statin therapy appear to increase their risk for cardiovascular disease mortality and all-cause mortality, according to results of a study published in Arthritis Care & Research.

For the population-based longitudinal study, researchers used administrative health data to analyze mortality outcomes in 4,102 people with rheumatoid arthritis and incident statin use from 1996 to 2006. Of the 4,102, 60% were women and the mean age was 67 years. Statin discontinuation was defined as persistent nonuse for at least 3 months anytime during prescribed statin therapy. With statin discontinuation as a time dependent variable, Cox’s proportional hazard models were used. Multivariable models were adjusted for age, sex, comorbidities and risk factors for mortality, and proxy indicators of rheumatoid arthritis severity.

The researchers found that about 45% of the cohort discontinued statin therapy at least once during the 4-year follow-up period. Researchers reported 198 deaths from CVD (31% from MI and 15% from stroke) and 467 deaths overall. Statin discontinuation was found to be associated with 60% increased risk of death from CVD and 79% for deaths from all causes. The association between statin discontinuation and mortality outcomes was not modified by timing of first prescription, age, or sex (P>.29), the researchers said.

“Our study provides evidence of the harmful effects of ceasing statin therapy,” Mary De Vera, PhD, of the University of British Columbia School of Population and Public Health and Arthritis Research Centre of Canada, said in a press release. “Our study findings emphasize the importance of medication compliance in rheumatoid arthritis patients who are prescribed statins.”

Disclosure: The study was funded by the Canadian Institutes of Health Research, Canadian Arthritis Network/The Arthritis Society of Canada, Michael Smith Foundation for Health Research and Canadian Institutes of Health Research.