Longitudinal cohort study for Statin use and knee osteoarthritis outcomes

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Created On: 20/01/2020

Longitudinal cohort study for Statin use and knee osteoarthritis outcomes

The pleiotropic effects of statins have already been established, however there is limited evidence estimating the association between use of statins use and knee OA outcomes.

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Key take away

Statins have considerable anti-inflammatory and immune-regulating properties. The study results confirmed that the use of statins specifically atorvastatin significantly lowered the risk of developing knee pain, which could have promising future benefits for knee osteoarthritis (OA) management.

Background

The pleiotropic effects of statins have already been established, however there is limited evidence estimating the association between use of statins use and knee OA outcomes. The present study was carried out in North American individuals to rule out if use of statins lowers the risk of radiographic symptomatic knee OA (SxOA) and, radiographic (ROA) and pain.

Method

In this longitudinal cohort study, a total of 4,448 community‐dwelling adults from the OA Initiative were followed‐up for 4 years. Self-report information was utilized to define the use of statins (including the type of statin and time from baseline). This was further confirmed by a trained interviewer. Knee OA outcomes encompassed incident:

ROA
SxOA, as the new onset of a combination of a painful knee and ROA
Knee pain worsening, i.e. a Western Ontario and McMaster Universities Osteoarthritis Index difference between baseline and each annual exam ≥14%

Result

At the baseline, statins were used by 1,127 participants ( 25.3%). Any statins use was not connected with the decreased risk of pain worsening (relative risk, RR=0.97; 95%CI, confidence intervals, CI: 0.93‐1.02), incident ROA or SxOA as per the multivariable Poisson regression analysis with the robust variance estimators. But, statins use for more than 5 years (RR=0.91; 95%CI: 0.83‐0.997), and atorvastatin use (RR=0.95; 95%CI: 0.91‐0.996) were connected with a reduced risk of developing pain, while rosuvastatin to higher risk (RR=1.18; 95%CI: 1.12‐1.24). Further, the findings were confirmed by the adjustment for the propensity score.

Conclusion

The investigators were unable to confirm the effect of statins use on knee OA. However, in patients who used statins for more than 5 years and those who used atorvastatin, lower risk of knee pain development was noticed.