Kwak Donghee, Moon Seok-Joo, Park Jong Woong, Lee Duk Hee, Lee Jung Il
Department of Orthopedic Surgery, Korea University Anam Hospital, Seoul, Republic of Korea.
Smart Healthcare Center, Korea University Guro Hospital, Seoul, Republic of Korea.
Orthop J Sports Med. 2023 Jul 14;11(7):23259671231167851. doi: 10.1177/23259671231167851. eCollection 2023 Jul.
Previous longitudinal cohort studies have reported the conflicting results of the relationship between statin use and the development of tendinopathy disorder. It is unclear if there is a relationship between statin use, particularly the type or cumulative doses, and the development of tendinopathy disorder.
To investigate an association between statin treatment and the development of tendinopathy.
Cohort study; Level of evidence, 3.
A total of 594,130 participants were enrolled in this study in 2002 and evaluated until 2015. There were 84,102 statin users and 168,204 nonusers (controls) selected at a ratio of 1:2 using propensity score matching analysis. The types of included tendinopathy were as follows: (1) trigger finger, (2) radial styloid tenosynovitis, (3) elbow epicondylitis, (4) rotator cuff tendinopathy, and (5) Achilles tendinitis. Cox proportional hazards models with time-varying covariates were constructed to identify the association between statin use and tendinopathy development.
Statin treatments regardless of statin types were associated with a significantly greater risk of all types of tendinopathy development (hazard ratio, 1.435; 95% CI, 1.411-1.460) compared with no statin treatment. A trend toward risk reduction was observed according to cumulative statin doses, which was indicated by hazard ratios of 2.337 (95% CI, 2.269-2.406), 2.210 (95% CI, 2.132-2.290), and 1.1 (95% CI, 1.098-1.146) in patients with cumulative defined daily doses of 90, 91-180, and >180, respectively.
This nationwide population-based cohort study suggests that statin use regardless of the statin type was associated with a greater risk of tendinopathy compared with that of nonusers. The risk of tendinopathy development was diluted with the increasing cumulative defined daily dose.
既往纵向队列研究报告了他汀类药物使用与肌腱病发生之间相互矛盾的结果。目前尚不清楚他汀类药物的使用，尤其是药物类型或累积剂量，与肌腱病的发生是否存在关联。
研究他汀类药物治疗与肌腱病发生之间的关联。
队列研究；证据等级为3级。
2002年共有594,130名参与者纳入本研究，并随访至2015年。采用倾向得分匹配分析，按照1:2的比例选取84,102名他汀类药物使用者和168,204名非使用者（对照）。纳入的肌腱病类型如下：（1）扳机指；（2）桡骨茎突狭窄性腱鞘炎；（3）肘外侧炎；（4）肩袖肌腱病；（5）跟腱炎。构建具有时变协变量的Cox比例风险模型，以确定他汀类药物使用与肌腱病发生之间的关联。
与未使用他汀类药物相比，无论他汀类药物类型如何，使用他汀类药物均与所有类型肌腱病发生的风险显著增加相关（风险比，1.435；95%可信区间，1.411-1.460）。根据累积他汀类药物剂量观察到风险降低的趋势，累积限定日剂量分别为90、91-180和>180的患者的风险比分别为2.337（95%可信区间，2.269-2.406）、2.210（95%可信区间，2.132-2.290）和1.1（95%可信区间，1.098-1.146）。
这项基于全国人群的队列研究表明，与未使用者相比，无论他汀类药物类型如何，使用他汀类药物均与肌腱病风险增加相关。随着累积限定日剂量的增加，肌腱病发生的风险降低。
