College of Pharmacy, University of Utah, Salt Lake City.
J Manag Care Spec Pharm. 2021 Mar;27(3):296-305. doi: 10.18553/jmcp.2021.27.3.296.
Patients with rheumatoid arthritis (RA) have higher rates of mortality attributed to the inflammatory nature and the associated burden of cardiovascular complications. Previous research indicates that treatment with statin therapy may play a role in reducing the mortality rate of RA patients, but similar evidence in U.S. patients is lacking. To assess the association between statin use and overall mortality among RA patients in the United States. A population-based study of RA patients with incident statin use was conducted. Patients aged ≥ 18 years with a diagnosis of RA between January 2007 and December 2015 were included and reviewed for the use of statin medication. Time stratified propensity score matching was used to adequately balance the comparison groups. Logistic regression and Cox proportional hazard models were used to estimate the association. 19,614 people fulfilled the inclusion criteria for the study out of which 2,089 were statin users. There were 1,883 statin users that were matched to 1,883 statin nonusers. Baseline characteristics were well balanced across the 2 groups after matching. The hazards ratio for all-cause mortality in patients with RA for statin users was 0.72 (95% CI = 0.56-0.91; = 0.008) compared with statin nonusers. Compared with no use of statins, current statin use is associated with 28% lower risk of mortality in RA patients. Decision makers and providers should consider and support integration of these results into the current clinical guidelines for delivering quality health care to RA patients. No outside funding supported this study. The authors received no financial support for the research, authorship, and/or publication of this article. The authors have no affiliations with or involvement in any organization or entity with any financial interest or nonfinancial interest in the subject matter or materials discussed in this manuscript.
类风湿关节炎(RA)患者的死亡率较高,这归因于其炎症性质和相关心血管并发症的负担。先前的研究表明,他汀类药物治疗可能在降低 RA 患者的死亡率方面发挥作用,但美国患者缺乏类似的证据。评估他汀类药物治疗在降低美国 RA 患者总体死亡率方面的作用。对有他汀类药物治疗的 RA 患者进行了一项基于人群的研究。纳入了年龄≥18 岁,在 2007 年 1 月至 2015 年 12 月期间被诊断为 RA,且使用过他汀类药物的患者。采用时间分层倾向评分匹配来充分平衡比较组。采用 logistic 回归和 Cox 比例风险模型来评估关联。共有 19614 人符合研究纳入标准,其中 2089 人为他汀类药物使用者。有 1883 名他汀类药物使用者与 1883 名他汀类药物非使用者相匹配。匹配后两组的基线特征差异不大。在 RA 患者中,与他汀类药物非使用者相比,他汀类药物使用者的全因死亡率风险比为 0.72(95%CI=0.56-0.91;P=0.008)。与未使用他汀类药物相比,目前使用他汀类药物与 RA 患者的死亡率降低 28%相关。决策者和提供者应考虑并支持将这些结果纳入目前为 RA 患者提供高质量医疗保健的临床指南中。本研究无外部资金支持。作者在研究、撰写和/或发表本文时未获得任何财务支持。作者与任何对本文讨论的主题或材料有财务利益或非财务利益的组织或实体没有隶属关系或参与关系。