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High-dose statins 'linked with reduction in osteoarthritis risk'

Statins may have an unintended beneficial consequence for some patients, suggests UK research showing that taken at higher doses the lipid-lowering drugs are associated with reductions in incident osteoarthritis.

The study

Researchers from Keele University analysed data from the UK General Practice Research Database on 16,609 adult patients, aged 40 years and older, with cardiovascular disease and no clinical record of osteoarthritis. The team used linked prescribing records to look at the incidence of clinically defined osteoarthritis over 10 years according to statin use.

The findings

Overall, 4,976 of the patients had been using statins for at least two years and 11,633 were not using statins. Over the 10-year follow-up, the researchers found that patients taking statins at the highest doses had a lower incidence of osteoarthritis compared with non-users of statins.

Among patients in the top quartile of statin doses, taking 18.5 mg or more daily, the incidence of osteoarthritis was around 60% lower than in the non-users group, while for those in the second highest quartile, with a daily dose of between 10 and 18.5 mg, the rate was 20% lower.

By contrast, patients taking lower doses of statins than this had increased rates of osteoarthritis, with 1.3 times the rate among non-users seen in those taking 4.7 to 9.9 mg daily, and 2.6 times the rate of non-users among those taking the lowest doses of up to 5 mg daily.

The researchers say their findings could not be explained by the severity of patients’ cardiovascular disease, or concomitant use of painkilling drugs, nor by age, gender, deprivation, baseline cholesterol levels or BMI.

What does it mean for GPs?

The findings suggest that in future GPs could choose to prescribe higher statin doses among patients at particular risk of developing osteoporosis. The authors conclude: ‘The potential clinical implication is that osteoarthritis management may share preventative approaches with cardiovascular disease.’

J Gen Intern Med 2013, online 8 March

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