Session Title: Vasculitis II
Session Type: Abstract Submissions (ACR)
Background/Purpose: Statins are widely prescribed to reduce the risk of cardiovascular ischemic events, but also present immunoregulatory effects promoting a shift from a TH-1 to a TH-2 immune response. The aim of our study was to investigate the potential relationship between exposure to statins, GCA occurrence and prednisone requirement in the general population.
Methods: The cohort includes incident GCA patients of the Midi-Pyrénées County, south of France from January 2005 to December 2008. Incident GCA cases were selected in the French National Health Insurance system database. For each patient, two age- and paired- controls were selected in the same database. Endpoints were GCA occurrence, cumulative prednisone doses and time until maintenance of low prednisone doses (LPD) (i.e < 5 mg prednisone per day for at least 6 months). Statin exposure was measured during the 6 months before the date of first prednisone prescription and as a time-dependent co-variable during the course of GCA for cases and controls. Patients were followed up to April 2011.
Results: The study included 103 patients (80 women, mean age 74.8 ± 9 years, mean follow-up 48.9 ± 14.8 months) and 206 controls. Twenty-eight (27.2%) patients versus 45 (21.8%) controls had a sustained exposure to statins before the index date (adjusted OR = 0.70 [0.4–1.2], p = 0.22). A total of 81 patients reached a maintenance of LPD during the follow-up period : respectively 48%, 70%, 85% and 89% at 2, 3, 4 and 5 years of follow-up. The mean time necessary to reached a maintenance of LPD was 24.3 ± 11.2 months. Their mean cumulative prednisone dose at this time was 11.4 ± 6.1 g. Statin exposure at diagnosis was associated with a higher rate of remission, however this effect was not present when statin exposure was treated as a time-dependent covariate (adjusted HR =1.06 [0.81–1.40], p> 0.05). Cumulative prednisone doses did not differed according to statin exposure.
Conclusion: We found no influence of statin therapy on the occurrence of GCA or on prednisone requirement in a French population-based GCA cohort.
J. L. Montastruc,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/statins-do-not-influence-occurrence-or-prednisone-requirement-of-giant-cell-arteritis-a-french-population-based-cohort-study/