Statin use and knee osteoarthritis progression: Results from a post-hoc analysis of the SEKOIA trial.
Florent Eymard, Camille Parsons, Mark H Edwards, Florence Petit-Dop, Jean-Yves Reginster, Olivier Bruyère, Xavier Chevalier, Cyrus Cooper, Pascal Richette
Author Information
Florent Eymard: Department of rheumatology, Henri-Mondor hospital, AP-HP, 94010 Créteil cedex, France.
Camille Parsons: MRC lifecourse epidemiology unit, Southampton general hospital, Southampton SO16 6YD, UK.
Mark H Edwards: MRC lifecourse epidemiology unit, Southampton general hospital, Southampton SO16 6YD, UK.
Florence Petit-Dop: Innovative pole of rheumatology, Servier, 92150 Suresnes, France.
Jean-Yves Reginster: Department of public health and health economics, university of Liege, 4020 Liege, Belgium.
Olivier Bruyère: Department of public health and health economics, university of Liege, 4020 Liege, Belgium.
Xavier Chevalier: Department of rheumatology, Henri-Mondor hospital, AP-HP, 94010 Créteil cedex, France.
Cyrus Cooper: MRC lifecourse epidemiology unit, Southampton general hospital, Southampton SO16 6YD, UK.
Pascal Richette: Department of rheumatology, Lariboisière hospital, AP-HP, 75475 Paris cedex 10, France; Inserm U1132, university Paris 7, Lariboisière hospital, AP-HP, 75475 Paris cedex 10, France. Electronic address: pascal.richette@aphp.fr.
OBJECTIVE: Epidemiological and experimental studies have suggested that lipid disorders might be involved in the pathophysiology of knee osteoarthritis (OA). Studies assessing the effect of statins on knee OA progression have shown conflicting results. We investigated the impact of statin use on radiological progression in patients with radiological and symptomatic knee OA. METHODS: In total, 336 patients from the placebo arm of SEKOIA trial completed the 3-year follow-up and were included in this post-hoc analysis. Statin use was recorded at baseline interview. Minimal medial tibiofemoral joint space was measured on plain radiographs by an automated method at baseline and then annually. Radiologic progression was defined as joint space narrowing≥0.5mm over 3 years. RESULTS: Overall, 71 patients were statin users (21.1%). They had a higher BMI (31.1±5.3 vs. 29.3±5.2kg/m, P=0.008), a higher sum of metabolic factors (≥3 factors: 43.7% vs 7.2%; P for trend<0.001) and a higher rate of radiological progression (49.3% vs. 32.1%, P=0.007) as compared to statin non-users. The significant association between radiological progression and statin use was independent of age, gender, WOMAC global score, disease duration, baseline joint space width, hypertension, type 2 diabetes, obesity (BMI>30kg/m) and cardiovascular diseases [relative risk 1.49 (95% CI: 1.10-2.02), P=0.010]. CONCLUSION: Among patients with knee OA, statin use was associated with radiological worsening over 3 years, regardless of other potential confounding factors (obesity, type 2 diabetes, hypertension, disease duration, symptom intensity and radiological severity).
