Background/Purpose: Studies evaluating the effect of statin use on the risk of rheumatoid arthritis (RA) onset have shown conflicting results. Most of these studies evaluated European populations while data from the US are scarce. We aimed to assess the association between statin use and RA occurrence using claims data from the US population.

Methods: For this case-control study, we used OptumLabs Data Warehouse database, a large administrative database of commercially insured and Medicare Advantage beneficiaries, to identify cases of RA and matched controls. Cases were defined as patients with 2 or more diagnoses of RA in 2011-2017 who were ≥18 years old, filled ≥1 prescription for a conventional or biologic disease modifying anti-rheumatic drug or glucocorticoid, and had no diagnoses of RA or relevant therapies during ≥12 months of prior medical/pharmacy coverage. Controls were persons without RA matched 1:1 to RA cases on age, sex, census region and calendar year. Statin use was defined as any filled prescription for a statin medication in the 12 months prior to RA incidence/index date. All patients with available data on statins were used in this analysis. Logistic regression models were used to estimate odds ratios (OR) with 95% confidence intervals (CI).

Results: The study included 42,865 cases with RA (mean age 57.6, 74.9% female) and 42,848 matched controls (mean age 57.6, 74.9% female). All patients in both groups had at least 12 months of prior medical/pharmacy coverage during which there were 15,391 (36%) statin users among RA patients and 13,892 (32%) statin users among the matched controls. Statin use was associated with increased risk of RA: unadjusted OR 1.17, 95%CI 1.14-1.20; OR adjusting for age, sex, race, calendar year of RA diagnosis and census region: 1.20, 95%CI 1.16-1.23. When we adjusted for additional comorbidities, including myocardial infarction, congestive heart failure, peripheral vascular disease, cerebrovascular disease, diabetes with or without organ damage, hypothyroidism, liver disease, metastatic cancer, obesity, and renal failure, the association remained statistically significant: OR 1.12, 95%CI 1.09, 1.16. With adjustment for age, sex, race, calendar year of RA diagnosis, census region and Charlson’s comorbidity index, we had slightly attenuated but overall similar results: OR 1.08, 95%CI 1.04, 1.11.

Conclusion: This large nationwide study showed increased risk of RA in statin-users vs non-users. The underlying mechanisms for this association require further investigation.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/statin-use-is-associated-with-increased-risk-of-ra-in-us-population-results-from-a-large-nationwide-study/