Heidari Behzad, Babaei Mansour, Yosefghahri Behnaz
Mobility Impairment Research Centre, Babol University of Medical Sciences, Babol, Iran.
Department of Medicine, Division of Rheumatology, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.
Mediterr J Rheumatol. 2021 Sep 30;32(3):227-236. doi: 10.31138/mjr.32.3.227. eCollection 2021 Sep.
Several traditional risk factors of atherosclerosis such as age, obesity, and altered lipid metabolism are shared with osteoarthritis (OA). Metabolic abnormalities and atheromatous vascular disease are linked with systemic inflammation and progression of OA. Hence, treatment of OA with statins is expected to improve metabolic abnormalities and prevent OA progression. Many studies which have addressed this issue found inconsistent results. This review aims to elucidate the effect of statins in OA by summarizing the existing data.
Potential studies in English language published in Medline/PubMed, Scopus and Google Scholar since 2000 were searched by using keywords such as osteoarthritis, statins, progression, treatment, prevalence, synovitis, pain. Fourteen papers were found to be relevant and were summarised.
Data regarding symptomatic effect of statins in OA are scarce and the results varied from no effect to a small improvement or even increased risk of pain in knee OA. However, most studies on the incidence and progression of OA found a significant decreased risk of incident OA, as well as reduced risk of radiographic progression in statin users vs. non-users. Factors such as patient adherence, duration of treatment, and higher cumulative statin doses were associated with greater efficacy.
Existing data indicate a preventing effect of statin therapy on OA progression. However, unless a formal meta-analysis with weight analysis is made, a conclusion cannot be drawn.
动脉粥样硬化的一些传统危险因素,如年龄、肥胖和脂质代谢改变,与骨关节炎(OA)相同。代谢异常和动脉粥样硬化性血管疾病与全身炎症及OA的进展相关。因此,使用他汀类药物治疗OA有望改善代谢异常并预防OA进展。许多探讨此问题的研究结果并不一致。本综述旨在通过总结现有数据阐明他汀类药物在OA中的作用。
使用骨关节炎、他汀类药物、进展、治疗、患病率、滑膜炎、疼痛等关键词,检索自2000年以来发表在Medline/PubMed、Scopus和谷歌学术上的英文潜在研究。发现14篇相关论文并进行了总结。
关于他汀类药物对OA症状性影响的数据稀少,结果从无影响到稍有改善,甚至在膝关节OA中疼痛风险增加不等。然而,大多数关于OA发病率和进展的研究发现,与未使用他汀类药物者相比,使用他汀类药物者发生OA的风险显著降低,影像学进展风险也降低。患者依从性、治疗持续时间和更高的他汀类药物累积剂量等因素与更大的疗效相关。
现有数据表明他汀类药物治疗对OA进展有预防作用。然而,除非进行带有权重分析的正式荟萃分析,否则无法得出结论。