Statin use linked with reduced mortality among patients with AS and PsA

WASHINGTON — Statin use was associated with a 32% reduction in mortality in a large cohort of patients with ankylosing spondylitis and psoriatic arthritis, according to findings presented at the American College of Rheumatology Annual Meeting.

Amar Oza, MD, and colleagues compared the survival benefit of statin use in a cohort of 2,904 patients with ankylosing spondylitis (AS) and psoriatic arthritis (PsA) with those from a propensity-matched cohort of comparators who were not using statins.

“The use of statins in AS and psoriatic arthritis have been more limited,” Oza said.

During a mean follow-up of 5.3 years, 271 statin users died compared with 376 individuals during 5.15 years of follow-up among controls. The mortality incidence rate was 17.6 per 1,000 for statin users and 25.1 per 1,000 person-years in the non-statin group.

Initiation of statins was associated with a reduction in all-cause death of 32% (hazard ratio [HR] = 0.68).

“Our sensitivity analyses also showed similarly significant results,” Oza said.

Researchers also compared unmatched cohorts to determine whether the propensity score matching was effective. In that comparison of 3,389 statin initiators and 3,389 statin non-users, statin use was associated with a 44% increase in mortality (HR = 1.44).

“This confirms that statins are generally prescribed in sicker patients who will go on to have a higher cumulative mortality than patients not requiring statin treatment,” Oza said.

Baseline parameters were similar in the treatment and control groups. Researchers used a group of 50 variables, including disease duration, socioeconomic status, BMI, lifestyle factors and medication use, to conduct the multivariable analysis.

“When we break down our two groups of patients separately — ankylosing spondylitis and psoriatic arthritis — we see a trend that becomes significant when the two patient populations are combined in the analysis,” Oza said.

He concluded that statin therapy may reduce cardiovascular risk and overall mortality in patients with AS and PsA.

“The magnitude of this association is larger than that seen in rheumatoid arthritis, as well as in those of the general population,” he said. “There are not strong evidence-based guidelines for the management of cardiovascular risk in ankylosing spondylitis and psoriatic arthritis. Future investigation in this area can provide the high-level evidence to define the role of statins in these diseases.” – by Rob Volansky

Reference:

Oza A, et al. Abstract #910. Presented at: The American College of Rheumatology Annual Meeting; Nov. 11-16, 2016. Washington.

Disclosure: Oza reports no relevant financial disclosures.