Neuroscience Institute, Aging Branch, Padova, Italy.
Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain, and Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.
Arthritis Care Res (Hoboken). 2019 Aug;71(8):1052-1058. doi: 10.1002/acr.23735. Epub 2019 Jul 8.
Statins have several pleiotropic effects, but the literature regarding the possible relationship between use of statins and outcomes in knee osteoarthritis (OA) is limited. The aim of this study was to investigate whether statin use is associated with a lower risk of radiographic OA (ROA), radiographic symptomatic knee OA, and pain in North American individuals.
A total of 4,448 community-dwelling adults from the Osteoarthritis Initiative were followed for 4 years. Statin use (including the time from baseline and the type of statin) was defined through self-report information and confirmed by a trained interviewer. Knee OA outcomes included incident ROA, symptomatic knee OA (new onset of a combination of a painful knee and ROA), and knee pain worsening (i.e., a Western Ontario and McMaster Universities Osteoarthritis Index difference between baseline and each annual examination ≥14%).
At baseline, 1,127 participants (25.3% of the total population) used statins. Based on a multivariable Poisson regression analysis with robust variance estimators, any use of statins was not associated with a lower risk of pain worsening (relative risk [RR] 0.97, 95% confidence interval [95% CI] 0.93-1.02), incident ROA, or symptomatic knee OA. However, statin use for more than 5 years (RR 0.91, 95% CI 0.83-0.997) and use of atorvastatin (RR 0.95, 95% CI 0.91-0.996) were associated with a reduced risk of developing pain, while rosuvastatin use was associated with a higher risk (RR 1.18, 95% CI 1.12-1.24). Analysis with adjustment for the propensity score confirmed these findings.
The effect of statin use on knee OA outcomes remains unclear, although in our study, a significantly lower risk of developing knee pain was observed in individuals using statins for >5 years and those using atorvastatin.
他汀类药物具有多种多效性作用，但关于他汀类药物使用与膝骨关节炎（OA）结局之间可能关系的文献有限。本研究旨在调查他汀类药物的使用是否与北美人群的放射学 OA（ROA）、放射学症状性膝 OA 和疼痛的风险降低相关。
共纳入来自 Osteoarthritis Initiative 的 4448 名社区居住的成年人，随访 4 年。通过自我报告信息和经过培训的访谈员确认来定义他汀类药物的使用（包括从基线开始的时间和他汀类药物的类型）。膝 OA 结局包括新发 ROA、症状性膝 OA（疼痛性膝关节和 ROA 新发病例的组合）和膝关节疼痛恶化（即，Western Ontario and McMaster Universities Osteoarthritis Index 在基线和每次年度检查之间的差异≥14%）。
在基线时，1127 名参与者（总人群的 25.3%）使用了他汀类药物。基于具有稳健方差估计的多变量泊松回归分析，任何他汀类药物的使用与疼痛恶化的风险降低无关（相对风险 [RR] 0.97，95%置信区间 [95%CI] 0.93-1.02）、新发 ROA 或症状性膝 OA。然而，他汀类药物使用超过 5 年（RR 0.91，95%CI 0.83-0.997）和使用阿托伐他汀（RR 0.95，95%CI 0.91-0.996）与发展为疼痛的风险降低相关，而使用瑞舒伐他汀与风险升高相关（RR 1.18，95%CI 1.12-1.24）。调整倾向评分的分析证实了这些发现。
他汀类药物使用对膝骨关节炎结局的影响仍不清楚，但在我们的研究中，使用他汀类药物超过 5 年和使用阿托伐他汀的个体观察到膝关节疼痛发展的风险显著降低。
