Medical Service, VA North Texas Health Care System, 4500 S. Lancaster Road, Dallas, TX, USA.
Division of Outcomes and Health Services Research, Departments of Internal Medicine and Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, USA.
Drug Saf. 2018 Oct;41(10):939-950. doi: 10.1007/s40264-018-0682-y.
Musculoskeletal conditions, including osteoarthritis (OA), result in tremendous disability and cost. Statins are among the most commonly prescribed medications and their use for primary prevention in many otherwise healthy individuals, including those who are physically active, is increasing. There is conflicting evidence regarding the relationship of statin use and musculoskeletal conditions. Given the rising disability associated with musculoskeletal conditions, understanding predisposing factors, including medication-related exposures, deserves further attention.
We examined the association between statin use and the risk of being diagnosed with non-traumatic arthropathies, use-related injury, and undergoing rehabilitation in a cohort with longitudinal follow-up.
Patients enrolled in a regional military healthcare system between 2003 and 2012 were evaluated in this retrospective cohort study. A propensity score was generated to match statin-users and nonusers using 115 baseline characteristics. Outcomes included ICD-9 diagnoses codes for Agency for Healthcare Research and Quality disease categories of: non-traumatic arthropathies, use-related injury and undergoing rehabilitation. Primary analysis examined the outcomes in statin-users and nonusers after propensity score matching using conditional logistic regression analysis.
Initially, 60,455 patients were identified. We propensity score-matched 6728 statin users with 6728 nonusers (52 years of age, ~ 47% women). In the propensity score-matched cohort, non-traumatic arthropathies occurred in 59.8% of statin users and 56.0% of nonusers [odds ratio (OR) 1.17, 95% confidence interval (95% CI) 1.09-1.25] and use related injury occurred in 31.9% of statin users and 29.8% of nonusers (OR 1.11, 95% CI 1.03-1.19). There was no difference between statin users and nonusers undergoing rehabilitation (22.6% among statin users, 21.9% among nonusers, OR 1.04, 95% CI 0.96-1.13).
Statin use was associated with a significant increased risk of non-traumatic arthropathies and use-related injury. Our results provide additional data that can inform patient and clinician conversations about the benefits and risks of statin use.
肌肉骨骼疾病，包括骨关节炎（OA），会导致巨大的残疾和经济负担。他汀类药物是最常用的药物之一，其在许多原本健康的个体（包括运动活跃的个体）中的主要预防用途正在增加。关于他汀类药物使用与肌肉骨骼疾病之间的关系，证据相互矛盾。鉴于与肌肉骨骼疾病相关的残疾人数不断增加，了解包括药物相关暴露在内的易患因素值得进一步关注。
我们在具有纵向随访的队列中，检查了他汀类药物使用与非创伤性关节炎、与使用相关的损伤和康复治疗的诊断风险之间的关系。
本回顾性队列研究纳入了 2003 年至 2012 年间在一个地区性军事医疗保健系统中登记的患者。使用 115 项基线特征生成倾向评分，以匹配他汀类药物使用者和非使用者。结果包括 Agency for Healthcare Research and Quality 疾病类别中的 ICD-9 诊断代码：非创伤性关节炎、与使用相关的损伤和康复治疗。主要分析使用条件逻辑回归分析，在倾向评分匹配后，比较他汀类药物使用者和非使用者的结果。
最初，确定了 60455 名患者。我们对 6728 名他汀类药物使用者和 6728 名非使用者进行了倾向评分匹配（52 岁，约 47%为女性）。在倾向评分匹配队列中，59.8%的他汀类药物使用者和 56.0%的非使用者发生了非创伤性关节炎（比值比[OR]1.17，95%置信区间[95%CI]1.09-1.25），31.9%的他汀类药物使用者和 29.8%的非使用者发生了与使用相关的损伤（OR 1.11，95%CI 1.03-1.19）。他汀类药物使用者和非使用者在接受康复治疗方面没有差异（22.6%的他汀类药物使用者，21.9%的非使用者，OR 1.04，95%CI 0.96-1.13）。
他汀类药物的使用与非创伤性关节炎和与使用相关的损伤的风险显著增加有关。我们的研究结果提供了更多数据，可以为患者和临床医生关于他汀类药物使用的益处和风险的讨论提供信息。
