Benefits of Statins Outweigh Diabetes Risk in Rheumatoid Arthritis, Researchers Say

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Benefits of Statins Outweigh Diabetes Risk in Rheumatoid Arthritis, Researchers Say

Researchers found that in people with rheumatoid arthritis, the benefits of taking statins — drugs taken to lower blood lipid (cholesterol and triglyceride) levels — outweigh a higher risk of developing diabetes, according to a new article published in the journal Arthritis Care & Research.

Rheumatoid arthritis (RA) is an inflammatory form of arthritis that is an autoimmune disease — meaning that it happens when your body’s own immune system mistakenly attacks tissues in your body. Like other types of arthritis, RA mainly affects the joints, and can affect several different joints at once. RA is distinguished from other forms of arthritis based on symptoms and various tests, including blood tests. RA is considered to be distinct from osteoarthritis (OA), the more common form of arthritis that occurs when the protective cartilage in joints wears down over time. But it’s also possible for a person to have both OA and RA.

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To make the latest recommendation on statins for people with rheumatoid arthritis, researchers looked at data from a group of thousands of people with RA who had their health outcomes tracked in a database called the UK Clinical Practice Research Datalink between 1989 and 2018. These participants were followed until they reached a combined endpoint of developing or experiencing a heart attack, a stroke, hospitalization for heart failure, type 2 diabetes, or death. Throughout the study period, each participant with RA who took statins was paired, for analysis, with two participants with RA who didn’t take statins. There were a total of 1,728 participants who started taking statins and 3,528 participants who didn’t take statins.

Benefits of statins outweigh risks in RA, researchers conclude

The researchers found that compared with participants who didn’t take statins, those who took statins were 32% less likely to have an adverse cardiovascular outcome or event, and 54% less likely to die of all causes. But at the same time, they were 33% more likely to develop type 2 diabetes. Another way to look at these numbers is that to prevent a single adverse cardiovascular outcome, 102 participants would need to take statins, while to prevent a single death, 42 participants would need to take statins. To develop a single additional case of type 2 diabetes, 127 participants would need to take statins, as noted in a Healio article on the study.

These outcomes — cardiovascular events, deaths, and new cases of diabetes — are distinct and therefore can’t be weighed against each other without assigning greater value to certain outcomes. That’s exactly what the researchers did, though, in concluding that the benefits of taking statins outweigh the risks in people with rheumatoid arthritis — since according to their judgment, the reduced risk of death was more important than the smaller increase risk of developing type 2 diabetes. While type 2 diabetes might eventually contribute to a higher risk of death, any such risk was more than offset by a reduced risk of dying from other causes, including from cardiovascular disease — which is itself a leading cause of death in people with diabetes.

“Given that RA patients are less frequently assessed for [cardiovascular] risk factors and even less frequently treated with statins than the general population, our findings emphasize the importance of statin initiation in eligible RA patients with close monitoring for [type 2 diabetes],” the researchers wrote. “Further research would be helpful to identify other cause-specific mortality benefits of statins in RA” aside from a reduced risk of death from cardiovascular causes, they noted.

Want to learn more about maintaining healthy cholesterol? Read “Natural Ways to Lower Your Cholesterol,” “HDL: Nine Ways to Raise Your Good Cholesterol,” and “Statin Alternatives: Other Medications That Can Lower Cholesterol.”

Quinn Phillips

Quinn Phillips

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A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.

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