Lin Guan-Ling, Keller Joseph Jordan, Wang Li-Hsuan
School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei.
Department of Psychiatry, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA.
Cartilage. 2024 May 10:19476035241247700. doi: 10.1177/19476035241247700.
To investigate the effect of higher cumulative defined daily dose per year (cDDD/y) compared with lower cDDD/y of statin use in the incidence of any joint osteoarthritis (OA).
In this population-based retrospective cohort study, patients who were aged ≥40 years were newly initiated on statin therapy between 2002 and 2011, and had a statin prescription for ≥90 days in the first year of treatment were identified from the 2000 Longitudinal Generation Tracking Database. All patients were separated into groups with higher cDDD/y (>120 cDDD/y) and lower cDDD/y (≤120 cDDD/y; as an active comparator) values. Propensity score matching was performed to balance potential confounders. All recruited patients were followed up for 8 years. Marginal Cox proportional hazard models were used to estimate time-to-event outcomes of OA.
Compared with lower cDDD/y use, higher cDDD/y use did not reduce the risk of any joint OA (adjusted hazard ratio, 1.07; 95% confidence interval, 0.99-1.14). Dose-related analysis did not reveal any dose-dependent association. A series of sensitivity analyses showed similar results. Joint-specific analyses revealed that statin did not reduce the incidence of knee, hand, hip, and weight-bearing (knee or hip) OA.
Higher cDDD/y statin use did not reduce the risk of OA in this Taiwanese nationwide cohort study. The complexity of OA pathogenesis might contribute to the ineffectiveness of statin. Repurposing statin with its anti-inflammation properties might be ineffective for OA development, and balancing the catabolism and anabolism of cartilage might be a major strategy for OA prevention.
研究每年较高的累积限定日剂量（cDDD/y）与较低的cDDD/y他汀类药物使用对任何关节骨关节炎（OA）发病率的影响。
在这项基于人群的回顾性队列研究中，从2000年纵向世代追踪数据库中识别出2002年至2011年间新开始他汀类药物治疗、年龄≥40岁且在治疗第一年他汀类药物处方持续≥90天的患者。所有患者被分为cDDD/y较高（>120 cDDD/y）和cDDD/y较低（≤120 cDDD/y；作为活性对照）两组。进行倾向评分匹配以平衡潜在混杂因素。所有招募的患者随访8年。采用边际Cox比例风险模型估计OA的事件发生时间结局。
与较低的cDDD/y使用相比，较高的cDDD/y使用并未降低任何关节OA的风险（调整后风险比，1.07；95%置信区间，0.99 - 1.14）。剂量相关分析未发现任何剂量依赖性关联。一系列敏感性分析显示了相似的结果。特定关节分析表明，他汀类药物并未降低膝、手、髋和负重（膝或髋）OA的发病率。
在这项台湾全国性队列研究中，较高的cDDD/y他汀类药物使用并未降低OA风险。OA发病机制的复杂性可能导致他汀类药物无效。将具有抗炎特性的他汀类药物重新用于OA治疗可能无效，平衡软骨的分解代谢和合成代谢可能是预防OA的主要策略。
