Abstract

BACKGROUND: Patients with rheumatoid arthritis (RA) have higher rates of mortality compared to the general population. This is most likely due to the inflammatory nature of this disease and the burden of cardiovascular complications that are associated with it. Previous literature indicates that treatment with statin therapy may play a role in further reducing the mortality rate of patients with RA.

OBJECTIVE: To determine statin use in patients with RA reduced all-cause mortality rates.

METHODS: Patients with a diagnosis of RA in the University of Utah Data Warehouse from 2007 – 2015 were included and reviewed for use of statin medication. Patients who started statin medication prior to RA diagnosis were excluded. The primary endpoint was all-cause mortality defined by the date of death in the data warehouse. Propensity score matching was utilized to adequately balance groups and account for potential confounders. Patients were matched 1:1 on age, gender, BMI, comorbidities, and medication use. Tests for statistical significance and Cox Proportional Hazards Regression were utilized for analysis of the primary outcome.

RESULTS: Baseline characteristics for each group were well balanced after matching. The hazards ratio for all-cause mortality in patients with rheumatoid arthritis for statin users was 0.70 (95% CI 0.55 – 0.89; p <0.001) compared to non-statin users. In patients with rheumatoid arthritis, statin initiation was associated with a 30% lower risk of all-cause mortality.

CONCLUSION: Patients with RA who use statin medications have lower rates of all-cause mortality. The utility of statins in this population supports integrating them into current guidelines.