Statins could reduce mortality risk in patients with ankylosing spondylitis
medwireNews: Initiation of statin treatment is associated with a “substantially lower risk” for mortality among patients with ankylosing spondylitis (AS), researchers report.
“With systemic inflammation linked to accelerated atherosclerosis, patients with AS, similar to those with rheumatoid arthritis, are at an increased risk for cardiovascular disease (CVD) and mortality,” explain study author Hyon Choi (Massachusetts General Hospital, Boston, USA) and colleagues.
The team conducted a propensity score-matched analysis accounting for variables including disease duration, comorbidities, and lifestyle factors using data from The Health Improvement Network (THIN), a UK general population database, and compared mortality rates in matched cohorts of AS patients who did and did not initiate statin treatment in the same year.
As reported in the Annals of the Rheumatic Diseases, they found that 96 of 1108 patients receiving statin treatment died over a mean follow-up of 5.3 years, compared with 134 of 1108 patients who were not treated with statins over a mean follow-up of 5.1 years.
These findings translated into all-cause mortality rates of 16.5 and 23.8 per 1000 person–years in the statin and non-statin groups, respectively, meaning that patients initiating statin treatment had a 37% decreased risk for mortality.
“The magnitude of the inverse association between statin initiation and mortality was higher than that observed in multiple meta-analyses of statin use for primary prevention in the general population (ie, 9% and 14%),” write the researchers
“As patients with AS are affected by systemic inflammation and are at a higher risk for CVD, the dual anti-inflammatory and lipid-lowering effects of statins may be more pronounced than in the general population,” they suggest.
Choi and colleagues caution that their study was limited by a lack of information on cause-specific mortality, disease activity, and disease-modifying antirheumatic drug (DMARD) and biologic use in the THIN database.
“[C]onfirming our findings in a data set that can fully incorporate disease activity and DMARD information would be valuable,” they stress.
And given the current lack of strong evidence-based recommendations for cardiovascular screening in patients with AS, the researchers call for “further studies to generate the high-level evidence needed to define the role of statin use in AS care.”
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