根据2014年骨质疏松、骨关节炎和肌肉骨骼疾病世界大会(WCO)发布的一项研究，他汀类药物似乎与临床膝骨关节炎发病率降低没有关联。
4月3日，牛津大学医学博士Prieto-Alhambra发布这项研究。他与同事对西班牙一个大型数据库中年龄≥40岁患者的数据进行了回顾。
结果表明，脂类代谢改变与骨关节炎有关联，他汀类药物可能有潜在的助益作用。在这项名为Rotterdam的研究中，发现他汀类药物的使用与膝骨关节炎总体进展的下降有关。在一项基于Clinical Practice Research Data1ink数据的研究中，较高剂量及较长时间的他汀类药物使用与不使用他汀类药物相比，也与临床骨关节炎的明显降低有关。
Osteoarthritis Initiative研究发现，在一个周期为四年的研究中，他汀类药物使用与膝关节疼痛、功能或进展的改善没有关联。San Antonio Military Multiservice Market的数据发现，他汀类药物使用实际上增加了骨关节炎的风险。
在目前的研究中，他汀类药物使用事件被定义为：研究之前至少有6个月未使用他汀类药物，他汀类药物治疗开始后的头6个月药物使用比率要>70%。膝骨关节炎病例事件由研究中所记录的国际疾病分类标准编码 ICD-10确定。该分析包括26139名他汀类药物使用者和26139名非他汀类药物使用者。
对患者平均随访时间为4.8年。骨关节炎患者在他汀类药物使用者中为1862人，在非他汀类药物使用者中为2119人。骨关节炎事件发生率在他汀类药物用药患者中是16.3/1000人年，在非他汀类药物用药患者中为18.1/1000人年。
症状性膝骨关节炎的风险比是0.95。Prieto-Alhambra博士断定，分析结果显示他汀类药物使用与症状性膝骨关节炎发作没有关联。
Statins Do Not Prevent Knee Osteoarthritis: Presented at WCO
SEVILLE, Spain -- April 4, 2014 -- Statin treatment does not appear to be associated with a decrease in the incidence of clinical knee osteoarthritis, according to a study presented at the 2014 World Congress on Osteoporosis, Osteoarthritis, and Musculoskeletal Diseases (WCO).
Daniel Prieto-Alhambra, MD, University of Oxford, Oxford, United Kingdom, presented the study on April 3. He and colleagues elsewhere examined data from men and women ≥40 years of age who were enrolled in a large database in Spain. The database contains anonymised longitudinal electronic medical records for 5 million individuals living in Catalonia.
Recent studies have suggested that altered lipid me-tabolism is associated with osteoarthritis and that statins may have a potential modifying role. In the Rotterdam study, statin use was found to be associated with >50% reduction in overall progression of knee osteoarthritis. In a study based on data from the Clinical Practice Research Data1ink, higher doses and longer use of statins were also associated with a significant reduction in clinical osteoarthritis compared with no use of statins.
Elsewhere, the Osteoarthritis Initiative Study found that statin use was not associated with improvements in knee pain, function, or progression over a 4-year study period. Data from the San Antonio Military Multiservice Market found that statin use actually increased the risk of osteoarthritis.
In the current study, incident statin use was defined as at least 6 months before study without any statin dispensation and with a medication possession ratio of >70% over the first 6 months after the start of statin therapy. Incident knee osteoarthritis cases were determined via International Classification of Diseases-10 codes that were recorded during the study.
The analysis included 26,139 statin users and 26,139 non–statin users.
At a median follow-up of 4.8 years, osteoarthritis was documented in 1,862 new statin-users and 2,119 nonusers. Incident osteoarthritis rates were 16.3 (95% confidence interval [CI], 15.6-17.1) per 1,000 person-years in statin users and 18.1 (95% CI, 17.3-18.8) per 1,000 person-years in non–statin users.
The hazard ratio for symptomatic knee osteoarthritis was 0.95 (95% CI, 0.89-1.00).
Dr. Prieto-Alhambra concluded that the results show no association between statin use and the onset of symptomatic knee osteoarthritis.
The 2014 World Congress on Osteoporosis, Osteoarthritis, and Musculoskeletal Diseases is sponsored by the International Osteoporosis Foundation (IOF) and the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO).
[Presentation title: Statin Use and Onset of Symptomatic Knee Osteoarthritis. Abstract P309]
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