Background/Purpose: Given conflicting evidence regarding statin use and the relationship with musculoskeletal conditions, and the rising disability and societal/personal repercussions associated with both osteoarthritis (OA) and back pain, understanding predisposing exposures (including medication related) deserve further attention. The objective of this study was to examine the association between statin use and the risk of being diagnosed with non-traumatic arthropathies, back disorders, and use-related injury in a propensity score-matched cohort with long-term follow-up.

Methods: This was a retrospective cohort study using clinical, administrative, and pharmacy data from 10/2003-3/2012 from patients enrolled in the military health care system in the San Antonio Multimarket region. Two treatment groups were defined: statin-users (those who newly received statins for ≥120 days) and non-users (included patients before initiating statins or never used statins). We excluded prevalent statin users, patients who had < 2 years of baseline period, or <1 medical encounter at followup period. A propensity score-matched cohort was generated to match statin-users and non-users using 115 variables (including personal history, social history, family history, healthcare utilization, baseline period start date, followup duration, comorbidities, Charlson comorbidity index, use of various classes of medications, and undergoing invasive and noninvasive cardiovascular procedures during the baseline period). Outcomes assessed included ICD-9 diagnoses codes for validated AHRQ disease categories of: non-traumatic arthropathies (ex. OA), back disorders (ex. intervertebral disc disorders), and use-related injury (ex. sprains and strains). As primary analysis (for space consideration we do not include the secondary and sensitivity analyses), we examined odds ratios of outcomes in statin-users and nonusers in the propensity score-matched cohort using conditional logistic regression analysis.

Results: A total of 60,455 patients were identified. We propensity score-matched 6728 non-users with 6728 statin-users (52 years of age, ~47% women). Statin users had a higher odds of non-traumatic arthropathies (odds ratio (OR) 1.17; 95%CI 1.09-1.25), back disorders (OR 1.27; 95%CI 1.19-1.36), and use related injury (OR 1.11; 95%CI 1.03-1.19).

Conclusion: Statin use was associated with a significant increase risk of non-traumatic arthropathies, back disorders, and use-related injury. These data challenge several existing studies implicating a protective effect of statins on musculoskeletal conditions. Our results provide additional motivation to further investigate the overall impact of statin therapy on musculoskeletal health, specifically if prescribed for primary prevention in physically active individuals.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/statin-use-and-increased-risk-of-musculoskeletal-conditions-a-retrospective-cohort-study-with-propensity-score-matching/