Study Highlights Importance of Therapy Compliance to Reduce Cardiovascular Disease Mortality
Patients with rheumatoid arthritis (RA) who discontinue use of statin
therapy are at increased risk of death from cardiovascular disease and
other causes. According to the findings of a population-based study now
available in Arthritis
Care & Research, a journal published by Wiley-Blackwell on
behalf of the American College of Rheumatology (ACR), RA patients should
be advised of the importance of compliance to their statin therapy to
reduce cardiovascular disease (CVD) mortality risk.
A report from the World Health Organization (WHO) estimates that RA
affects up to one percent of the population in developed countries.
Studies have shown that death rates among those with RA are 1.5-fold
higher than in the general population, with CVD cited at the leading
cause of mortality in this patient group. Statins—drugs such as
atorvastatin (Lipitor) and rosuvastatin (Crestor) that are used to lower
cholesterol and manage heart disease—are a common therapy for RA
patients who are at greater risk of heart disease. Previous research
reported 38% of RA patients permanently discontinue statin therapy,
consequently increasing their heart attack risk by 67%.
“Our study provides evidence of the harmful effects of ceasing statin
therapy,” said lead author Mary De Vera, Ph.D., with the University of
British Columbia School of Population & Public Health and Arthritis
Research Centre of Canada. Using data from the British Columbia Ministry
of Health records, researchers indentified 37,151 RA patients who
received health services between January 1996 and March 2006. Of those
with RA there were 4,102 patients who used statins. The team defined
statin discontinuation as non-use of the prescribed medication for three
months or more, anytime during the course of therapy.
The mean age of the RA group was 67 years, with 60% of the group being
women. More than 16,144 person-years of follow-up were recorded for
patients using statins, with roughly 45% of statin users discontinuing
therapy at least once during the 4-year follow-up period. The authors
reported 198 deaths from CVD and 467 deaths overall. Of the CVD deaths,
31% were from heart attacks and 15% from strokes.
Further analysis revealed that statin discontinuation was associated
with a 60% increased risk of CVD deaths and 79% for deaths from all
causes, which was not moderated by timing of the first statin
prescription, age, or gender. “RA patients who discontinue statin
therapy are at increased risk of death from cardiovascular disease,”
concludes Dr. De Vera. “Our study findings emphasize the importance of
medication compliance in RA patients who are prescribed statins.”
