Statin use linked to mortality reduction in ankylosing spondylitis, psoriatic arthritis

By Megan Brooks

NEW YORK (Reuters Health) - Patients with ankylosing spondylitis or psoriatic arthritis who take statins have a considerably lower risk of early death compared with those not on the drugs, according to a new study.

"Our findings suggest that patients with seronegative spondyloarthropathies like ankylosing spondylitis and psoriatic arthritis may benefit from the dual anti-inflammatory and lipid-lowering properties of statins, perhaps even more than the general population," Dr. Hyon Choi of Harvard Medical School and Massachusetts General Hospital in Boston told Reuters Health by email.

The findings were presented November 13 during a plenary session at the American College of Rheumatology annual meeting in Washington, D.C.

Ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are both associated with increased risk of death due to cardiovascular disease. "The expanding literature on the dual-role of statins to lower both inflammation and cholesterol levels has naturally led to interest in the role of statins in inflammatory arthritis," Dr. Amar Oza of Mass General, who also worked on the study, said in a news release.

"A randomized trial found such a dual benefit among patients with rheumatoid arthritis (RA), and a population-based study of patients with RA found a survival benefit associated with statin use as well. As such, we hoped to quantify the potential impact of statins in the seronegative spondyloarthropathies, as the risk of all-cause mortality and even cardiovascular-specific mortality has shown to be elevated in these conditions," Dr. Oza explained.

Using a U.K. general population database, the researchers identified more than 2,900 patients with AS or PsA initiating statin therapy and a like number of propensity matched AS or PsA patients who were not started on a statin.

Over an average of about five years, more patients who didn't start a statin died (376 vs. 271). Statin initiation was associated with a significant 33% reduction in dying from any cause.

"The magnitude of the inverse association appears to be larger than that observed in population-based cohort studies of patients with rheumatoid arthritis (21%) and in meta-analyses of randomized trials of the general population (9-14%), potentially due to the dual benefits of statin use (i.e. lipid lowering and anti-inflammatory effects) in patients with seronegative spondyloarthropathies," the researchers note in their meeting abstract.

"This observational study raises the potential that clinicians may have a lower threshold for starting their patients on statins to mitigate the increased mortality risk in these patients. To that effect, it sets the groundwork for potential clinical trials to come, which will provide high-level evidence about the impact statins have on their health," Dr. Choi told Reuters Health.

The study was supported by funding from the NIH's National Institute of Arthritis and Musculoskeletal and Skin Diseases. The authors have declared no conflicts of interest.

SOURCE: https://bit.ly/2fRAtsE

American College of Rheumatology Annual Meeting 2016.

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