Burkard T, Huegle T, Layton JB, Glynn RJ, Bloechliger M, Frey N, Jick SS, Meier CR, Spoendlin J. The risk of incident osteoarthritis of the hand in statin initiators:a sequential cohort study. Arthritis Care Res (Hoboken). 2018 Jun 8. doi: 10.1002/acr.23616.

OBJECTIVE: We aimed to investigate the association between statin therapy initiation and incident hand osteoarthritis (HOA).

METHODS: We performed a propensity score-matched cohort study using data from the UK-based Clinical Practice Research Datalink. Statin initiators had ≥1 statin prescription between 1996 and 2015 and were matched 1:1 on their propensity score to non-initiators within 10 sequential 2-year cohort entry blocks. After a 180-day run-in period, patients were followed in an "as treated" approach until a recorded diagnosis of HOA or until censoring (change in exposure status, development of an exclusion criterion, maximum follow-up 5.5 years). We applied Cox proportional hazard regression to calculate hazard ratios (HR) with 95% confidence intervals (CI) overall and in subgroups of sex, age, statin dose, statin agent, pre-existing dyslipidaemia and treatment duration. To compare results, we ran all analyses with negative and positive control outcomes and assessed generalised osteoarthritis (OA) as a secondary outcome. We further performed the overall analysis with an active comparator (topical glaucoma therapy initiators).

RESULTS: Among 233,608 statin initiators and the same number of non-initiators, we observed an overall HR of HOA of 0.98 (95% CI 0.88-1.09). The observed null result remained unchanged in all subgroups. Results were highly similar for generalised OA and negative control outcomes. Also the active comparator analysis showed a null result with a HR of HOA of 0.85 (95% CI 0.56-1.29). Previously known associations with positive control outcomes were observed.

CONCLUSION: There was no association between statin initiation and incident HOA in this study.

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