D'Amuri Andrea, Bordini Barbara, Pagani Mauro, Ciaffi Jacopo, D'Agostino Claudio, Di Martino Alberto, Faldini Cesare, Ursini Francesco
Unit of Internal Medicine, Azienda Ospedaliera Carlo Poma, Mantova, Italy.
Laboratory of Medical Technology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Emilia-Romagna, Italy.
Front Pharmacol. 2025 Apr 15;16:1492200. doi: 10.3389/fphar.2025.1492200. eCollection 2025.
Statins, widely used lipid lowering drugs, have been associated with pleiotropic beneficial effects. Notably, studies conducted and suggest a link between statins and bone metabolism. Observational data in humans also hint at a decreased fracture rate among statin users. Revision of total hip arthroplasty (THA) is a serious and costly medical event. Whether statins might influence THA failure is not clear. Aim of the current study is to assess how the preoperative use of statins may influence the risk of THA revision in patients with hip osteoarthritis (OA).
We performed a retrospective analysis of patients who underwent THA for OA in the Italian RIPO registry of Emilia-Romagna. Electronic health records were scrutinized to gather information regarding comorbidities and statin prescriptions. We employed propensity score (PS) matching to pair 1:1 statin users (SU) with statin non-users (SNU), considering factors such as age, sex, and the duration of follow-up. Survival of THA was compared between the two groups; secondary analyses were performed to ascertain the role of mortality, sex, indication for statin treatment, and statin potency or lipophilicity.
10,927 patients were classified as SU and PS-matched with SNU. SU showed a reduced risk of THA revision over a 15-year period (adjHR 0.76, 95% CI: 0.67-0.88; p < 0.001). Notably, this observation remained consistent regardless of the indication for statin therapy or the specific characteristics of the statin medications prescribed, and it was more pronounced among male patients (adjHR 0.64, 95% CI: 0.52-0.80, p < 0.001).
Our findings suggest that statin treatment is associated with a decreased risk of long-term THA revision in patients with OA, irrespective of the original indication for statin therapy.
他汀类药物是广泛使用的降脂药物，具有多种有益作用。值得注意的是，此前开展的研究表明他汀类药物与骨代谢之间存在联系。人体观察数据也提示他汀类药物使用者的骨折率降低。全髋关节置换术（THA）翻修是一项严重且成本高昂的医疗事件。他汀类药物是否会影响THA失败尚不清楚。本研究的目的是评估术前使用他汀类药物如何影响髋骨关节炎（OA）患者THA翻修的风险。
我们对意大利艾米利亚 - 罗马涅地区RIPO登记处接受OA - THA手术的患者进行了回顾性分析。仔细审查电子健康记录以收集有关合并症和他汀类药物处方信息。我们采用倾向评分（PS）匹配，将他汀类药物使用者（SU）与未使用者（SNU）按1:1配对，考虑年龄、性别和随访时间等因素。比较两组THA的生存率；进行二次分析以确定死亡率、性别、他汀类药物治疗指征以及他汀类药物效力或亲脂性的作用。
10927例患者被归类为SU并与SNU进行PS匹配。SU在15年期间THA翻修风险降低（校正风险比0.76，95%置信区间：0.67 - 0.88；p < 0.001）。值得注意的是，无论他汀类药物治疗指征或所开他汀类药物的具体特性如何，这一观察结果均保持一致，并且在男性患者中更为明显（校正风险比0.64，95%置信区间：0.52 - 0.80，p < 0.001）。
我们的研究结果表明，他汀类药物治疗与OA患者长期THA翻修风险降低相关，无论他汀类药物治疗的原始指征如何。
