Reduction of Cardiovascular Disease and Mortality Versus Risk of New‐Onset Diabetes Mellitus With Statin Use in Patients With Rheumatoid Arthritis
Authors' conclusion
Statins are associated with important reductions in CVD and mortality that outweigh the modest increase in type 2 DM risk in RA patients.
Study context
- Population
- Patients with Rheumatoid Arthritis (RA), UK Clinical Practice Research Datalink, 1989–2018
- Participants
- 1,768 vs 3,528
- Exposure
- Statin initiators vs matched concurrent nonusers
- Statinn = 1,768
- Nonusersn = 3,528reference
- Outcome
- Composite cardiovascular disease (CVD) (MI, stroke, hospitalised HF or CVD mortality), all-cause mortality and incident type 2 DM
Methodological detailsprevalent new-user cohort design, matched 1:2 by time-conditional propensity score, as-treated, Cox proportional hazards model
- Prevalent new-user cohort design
- Matched 1:2 by time-conditional propensity score
- As-treated
- Cox proportional hazards model
Main finding
As reported in the abstract
Composite CVD:
- MI
- Stroke
- Hospitalised HF
- CVD mortality
Hazard ratio
0.68
95% CI 0.51–0.90
Events by group
Observational data: associations, not effects.
Further findings
Per 100 person-years
| Outcome | Statin | Nonusers | HR (95% CI) | |
|---|---|---|---|---|
| All-cause mortality54% reduction; NNT in 1 year 42 | 2.8 | 4.1 | 0.46 (0.35–0.60) | |
| 0.20.5125Hazard ratio (log scale) |
Safety
Per 100 person-years
| Outcome | Statin | Nonusers | HR (95% CI) | |
|---|---|---|---|---|
| Incident type 2 DM33% increase; NNH in 1 year 127 | 3.0 | 2.0 | 1.33 (1.09–1.63) | |
| 0.512Hazard ratio (log scale) |
- Incident type 2 diabetes mellitus (DM): DM cohort: 3,608 statin initiators and 7,208 nonusers
Original publication
Reduction of Cardiovascular Disease and Mortality Versus Risk of New‐Onset Diabetes Mellitus With Statin Use in Patients With Rheumatoid Arthritis. Arthritis Care Res (Hoboken). Published 17 November 2022. doi:10.
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