Statin Use and Knee Osteoarthritis Outcomes: A Longitudinal Cohort Study

Nicola Veronese; Ai Koyanagi; Brendon Stubbs; Cyrus Cooper; Giuseppe Guglielmi; Renè Rizzoli; Patricia Schofield; Leonardo Punzi; N Al‐Daghri; Lee Smith; Stefania Maggi; Jean Yves Reginster

doi:10.1002/acr.23735

Statin Use and Knee Osteoarthritis Outcomes: A Longitudinal Cohort Study

Nicola Veronese^*, Ai Koyanagi, Brendon Stubbs, Cyrus Cooper, Giuseppe Guglielmi, Renè Rizzoli, Patricia Schofield, Leonardo Punzi, N Al‐Daghri, Lee Smith, Stefania Maggi, Jean Yves Reginster

^*Corresponding author for this work

School of Nursing and Midwifery

Research output: Contribution to journal › Article › peer-review

Abstract

ObjectiveStatins have several pleiotropic effects, but the literature regarding the possible relationship between use of statins and outcomes in knee osteoarthritis (OA) is limited. The aim of this study was to investigate whether statin use is associated with a lower risk of radiographic OA (ROA), radiographic symptomatic knee OA, and pain in North American individuals.MethodsA total of 4,448 community‐dwelling adults from the Osteoarthritis Initiative were followed for 4 years. Statin use (including the time from baseline and the type of statin) was defined through self‐report information and confirmed by a trained interviewer. Knee OA outcomes included incident ROA, symptomatic knee OA (new onset of a combination of a painful knee and ROA), and knee pain worsening (i.e., a Western Ontario and McMaster Universities Osteoarthritis Index difference between baseline and each annual examination ≥14%).ResultsAt baseline, 1,127 participants (25.3% of the total population) used statins. Based on a multivariable Poisson regression analysis with robust variance estimators, any use of statins was not associated with a lower risk of pain worsening (relative risk [RR] 0.97, 95% confidence interval [95% CI] 0.93–1.02), incident ROA, or symptomatic knee OA. However, statin use for more than 5 years (RR 0.91, 95% CI 0.83–0.997) and use of atorvastatin (RR 0.95, 95% CI 0.91–0.996) were associated with a reduced risk of developing pain, while rosuvastatin use was associated with a higher risk (RR 1.18, 95% CI 1.12–1.24). Analysis with adjustment for the propensity score confirmed these findings.ConclusionThe effect of statin use on knee OA outcomes remains unclear, although in our study, a significantly lower risk of developing knee pain was observed in individuals using statins for >5 years and those using atorvastatin.

Original language	English
Pages (from-to)	1052-1058
Number of pages	0
Journal	Arthritis Care & Research
Volume	71
Issue number	8
Early online date	8 Jul 2019
DOIs	https://doi.org/10.1002/acr.23735
Publication status	Published - Aug 2019

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10.1002/acr.23735

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@article{97e765f9e0b8439eafda2840558fcc86,

title = "Statin Use and Knee Osteoarthritis Outcomes: A Longitudinal Cohort Study",

abstract = "ObjectiveStatins have several pleiotropic effects, but the literature regarding the possible relationship between use of statins and outcomes in knee osteoarthritis (OA) is limited. The aim of this study was to investigate whether statin use is associated with a lower risk of radiographic OA (ROA), radiographic symptomatic knee OA, and pain in North American individuals.MethodsA total of 4,448 community‐dwelling adults from the Osteoarthritis Initiative were followed for 4 years. Statin use (including the time from baseline and the type of statin) was defined through self‐report information and confirmed by a trained interviewer. Knee OA outcomes included incident ROA, symptomatic knee OA (new onset of a combination of a painful knee and ROA), and knee pain worsening (i.e., a Western Ontario and McMaster Universities Osteoarthritis Index difference between baseline and each annual examination ≥14%).ResultsAt baseline, 1,127 participants (25.3% of the total population) used statins. Based on a multivariable Poisson regression analysis with robust variance estimators, any use of statins was not associated with a lower risk of pain worsening (relative risk [RR] 0.97, 95% confidence interval [95% CI] 0.93–1.02), incident ROA, or symptomatic knee OA. However, statin use for more than 5 years (RR 0.91, 95% CI 0.83–0.997) and use of atorvastatin (RR 0.95, 95% CI 0.91–0.996) were associated with a reduced risk of developing pain, while rosuvastatin use was associated with a higher risk (RR 1.18, 95% CI 1.12–1.24). Analysis with adjustment for the propensity score confirmed these findings.ConclusionThe effect of statin use on knee OA outcomes remains unclear, although in our study, a significantly lower risk of developing knee pain was observed in individuals using statins for >5 years and those using atorvastatin.",

author = "Nicola Veronese and Ai Koyanagi and Brendon Stubbs and Cyrus Cooper and Giuseppe Guglielmi and Ren{\`e} Rizzoli and Patricia Schofield and Leonardo Punzi and N Al‐Daghri and Lee Smith and Stefania Maggi and Reginster, {Jean Yves}",

year = "2019",

month = aug,

doi = "10.1002/acr.23735",

language = "English",

volume = "71",

pages = "1052--1058",

journal = "Arthritis Care & Research",

issn = "2151-464X",

number = "8",

}

TY - JOUR

T1 - Statin Use and Knee Osteoarthritis Outcomes: A Longitudinal Cohort Study

AU - Veronese, Nicola

AU - Koyanagi, Ai

AU - Stubbs, Brendon

AU - Cooper, Cyrus

AU - Guglielmi, Giuseppe

AU - Rizzoli, Renè

AU - Schofield, Patricia

AU - Punzi, Leonardo

AU - Al‐Daghri, N

AU - Smith, Lee

AU - Maggi, Stefania

AU - Reginster, Jean Yves

PY - 2019/8

Y1 - 2019/8

N2 - ObjectiveStatins have several pleiotropic effects, but the literature regarding the possible relationship between use of statins and outcomes in knee osteoarthritis (OA) is limited. The aim of this study was to investigate whether statin use is associated with a lower risk of radiographic OA (ROA), radiographic symptomatic knee OA, and pain in North American individuals.MethodsA total of 4,448 community‐dwelling adults from the Osteoarthritis Initiative were followed for 4 years. Statin use (including the time from baseline and the type of statin) was defined through self‐report information and confirmed by a trained interviewer. Knee OA outcomes included incident ROA, symptomatic knee OA (new onset of a combination of a painful knee and ROA), and knee pain worsening (i.e., a Western Ontario and McMaster Universities Osteoarthritis Index difference between baseline and each annual examination ≥14%).ResultsAt baseline, 1,127 participants (25.3% of the total population) used statins. Based on a multivariable Poisson regression analysis with robust variance estimators, any use of statins was not associated with a lower risk of pain worsening (relative risk [RR] 0.97, 95% confidence interval [95% CI] 0.93–1.02), incident ROA, or symptomatic knee OA. However, statin use for more than 5 years (RR 0.91, 95% CI 0.83–0.997) and use of atorvastatin (RR 0.95, 95% CI 0.91–0.996) were associated with a reduced risk of developing pain, while rosuvastatin use was associated with a higher risk (RR 1.18, 95% CI 1.12–1.24). Analysis with adjustment for the propensity score confirmed these findings.ConclusionThe effect of statin use on knee OA outcomes remains unclear, although in our study, a significantly lower risk of developing knee pain was observed in individuals using statins for >5 years and those using atorvastatin.

AB - ObjectiveStatins have several pleiotropic effects, but the literature regarding the possible relationship between use of statins and outcomes in knee osteoarthritis (OA) is limited. The aim of this study was to investigate whether statin use is associated with a lower risk of radiographic OA (ROA), radiographic symptomatic knee OA, and pain in North American individuals.MethodsA total of 4,448 community‐dwelling adults from the Osteoarthritis Initiative were followed for 4 years. Statin use (including the time from baseline and the type of statin) was defined through self‐report information and confirmed by a trained interviewer. Knee OA outcomes included incident ROA, symptomatic knee OA (new onset of a combination of a painful knee and ROA), and knee pain worsening (i.e., a Western Ontario and McMaster Universities Osteoarthritis Index difference between baseline and each annual examination ≥14%).ResultsAt baseline, 1,127 participants (25.3% of the total population) used statins. Based on a multivariable Poisson regression analysis with robust variance estimators, any use of statins was not associated with a lower risk of pain worsening (relative risk [RR] 0.97, 95% confidence interval [95% CI] 0.93–1.02), incident ROA, or symptomatic knee OA. However, statin use for more than 5 years (RR 0.91, 95% CI 0.83–0.997) and use of atorvastatin (RR 0.95, 95% CI 0.91–0.996) were associated with a reduced risk of developing pain, while rosuvastatin use was associated with a higher risk (RR 1.18, 95% CI 1.12–1.24). Analysis with adjustment for the propensity score confirmed these findings.ConclusionThe effect of statin use on knee OA outcomes remains unclear, although in our study, a significantly lower risk of developing knee pain was observed in individuals using statins for >5 years and those using atorvastatin.

U2 - 10.1002/acr.23735

DO - 10.1002/acr.23735

M3 - Article

SN - 2151-464X

VL - 71

SP - 1052

EP - 1058

JO - Arthritis Care & Research

JF - Arthritis Care & Research

IS - 8

ER -

Statin Use and Knee Osteoarthritis Outcomes: A Longitudinal Cohort Study

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