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dc.contributor.authorde Jong, Hilda J I
dc.contributor.authorCohen Tervaert, Jan Willem
dc.contributor.authorLalmohamed, Arief
dc.contributor.authorde Vries, Frank
dc.contributor.authorVandebriel, Rob J
dc.contributor.authorvan Loveren, Henk
dc.contributor.authorKlungel, Olaf H
dc.contributor.authorvan Staa, Tjeerd P
dc.date.accessioned2018-02-27T13:40:47Z
dc.date.available2018-02-27T13:40:47Z
dc.date.issued2018
dc.identifier.citationPattern of risks of rheumatoid arthritis among patients using statins: A cohort study with the clinical practice research datalink. 2018, 13 (2):e0193297 PLoS ONEen
dc.identifier.issn1932-6203
dc.identifier.pmid29474418
dc.identifier.doi10.1371/journal.pone.0193297
dc.identifier.urihttp://hdl.handle.net/10029/621456
dc.description.abstractWe examined the association between statin use and the risk of rheumatoid arthritis (RA), with special focus on describing the patterns of risks of RA during statin exposure in a large population-based cohort in the United Kingdom. In the Clinical Practice Research Datalink, patients aged ≥40 years with at least one prescription of statins (1995-2009) were selected, and matched by age (+/-5 years), sex, practice and date of first prescription of statins to non-users. The follow-up period of statin use was divided into periods of current, recent and past exposure, with patients moving between these three exposure categories over time. Time-dependent Cox models were used to derive hazard ratios (HRs) of RA, adjusted for disease history and previous drug use. The study population included 1,023,240 patients, of whom 511,620 were statin users. No associations were found between RA and current (HRadj,1.06;99%CI:0.88-1.27) or past statin users (HRadj,1.18;99%CI:0.88-1.57). However, in patients who currently used statins, hazard rates were increased shortly after the first prescription of statins and then gradually decreased to baseline level. The risk of developing RA was increased in recent statin users, as compared to non-users (HRadj,1.39;99%CI:1.01-1.90). The risk of RA is substantially increased in the first year after the start of statins and then diminishes to baseline level. These findings may suggest that statins might accelerate disease onset in patients susceptible to develop RA, but in other patients, statins are probably safe and well tolerated, even after prolonged use. Alternatively, we cannot rule out that confounding by cardiovascular risk factors and ascertainment bias may have influenced the findings.
dc.language.isoenen
dc.rightsArchived with thanks to PloS oneen
dc.titlePattern of risks of rheumatoid arthritis among patients using statins: A cohort study with the clinical practice research datalink.en
dc.typeArticleen
dc.identifier.journalPlos One 2018; 13(2):e0193297en
html.description.abstractWe examined the association between statin use and the risk of rheumatoid arthritis (RA), with special focus on describing the patterns of risks of RA during statin exposure in a large population-based cohort in the United Kingdom. In the Clinical Practice Research Datalink, patients aged ≥40 years with at least one prescription of statins (1995-2009) were selected, and matched by age (+/-5 years), sex, practice and date of first prescription of statins to non-users. The follow-up period of statin use was divided into periods of current, recent and past exposure, with patients moving between these three exposure categories over time. Time-dependent Cox models were used to derive hazard ratios (HRs) of RA, adjusted for disease history and previous drug use. The study population included 1,023,240 patients, of whom 511,620 were statin users. No associations were found between RA and current (HRadj,1.06;99%CI:0.88-1.27) or past statin users (HRadj,1.18;99%CI:0.88-1.57). However, in patients who currently used statins, hazard rates were increased shortly after the first prescription of statins and then gradually decreased to baseline level. The risk of developing RA was increased in recent statin users, as compared to non-users (HRadj,1.39;99%CI:1.01-1.90). The risk of RA is substantially increased in the first year after the start of statins and then diminishes to baseline level. These findings may suggest that statins might accelerate disease onset in patients susceptible to develop RA, but in other patients, statins are probably safe and well tolerated, even after prolonged use. Alternatively, we cannot rule out that confounding by cardiovascular risk factors and ascertainment bias may have influenced the findings.


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