Statins and Knee Osteoarthritis

People with rheumatoid arthritis (RA) have a much higher than average risk of heart disease, probably thanks to elevated levels of inflammation throughout their bodies. They’re hardly the only ones with a chronic disease who are in this position: People with diabetes, for instance, also face a high risk of heart disease, and current guidelines say that most diabetes patients should be taking a statin — cholesterol-lowering medication that may reduce the risk of heart attack and other serious cardiovascular events.

Should RA patients be treated similarly?

According to a new study, published in the journal Arthritis & Rheumatology, statins are indeed safe and effective for people with RA. The researchers designed a large (more than 3,000 participants), randomized, placebo-controlled trial in which RA patients were assigned to take atorvastatin (Lipitor) or a placebo.

At about the 2.5-year mark, they found that patients taking atorvastatin were 40 percent less likely to have experienced a cardiovascular event such as a heart attack or stroke. Although that sounds impressive, the authors said that there was no statistically significant difference between the atorvastatin and placebo groups, because the total number of people who had a cardiovascular event in either group was so small. (Only 2.4 percent of those in the placebo group had had a cardiovascular event, versus 1.6 percent in the treatment group.)

Although this study found that statins are safe for people with RA, “because of the low overall rate of cardiovascular events in the trial population, there is no indication for all patients with rheumatoid arthritis to be prescribed a statin,” study co-author Deborah Symmons, MD, of the University of Manchester, told the Wiley newsroom. (Wiley is the publisher of Arthritis & Rheumatology.) “This is unlike diabetes, where the great majority of patients are recommended to take a statin.”

The takeaway: Having RA in and of itself isn’t reason enough to take a statin, but if you have additional heart disease risk factors (such as high cholesterol, family history of heart disease, etc.), then you should feel confident that this medication is safe for people with RA to use.

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