Grégory Pugnet1, Laurent Sailler2, Robert Bourrel2, Jean-Louis Montastruc2, Maryse Lapeyre-Mestre2. 1. From the Faculté de Médecine, and the Laboratoire de Pharmacologie Médicale et Clinique, Université de Toulouse III; INSERM, UMR1027; Service de Médecine Interne, and the Service de Pharmacologie Clinique, Centre Hospitalier Universitaire (CHU) Toulouse; Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Service Médical Midi-Pyrénées, Toulouse, France.G. Pugnet, MD; L. Sailler, MD, PhD, Université de Toulouse III, INSERM, UMR1027, Service de Médecine Interne, CHU Toulouse; R. Bourrel, MD, Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Service Médical Midi-Pyrénées; J-L. Montastruc, MD, PhD; M. Lapeyre-Mestre, MD, PhD, Université de Toulouse III, INSERM, UMR1027, Laboratoire de Pharmacologie Médicale et Clinique, Université de Toulouse III, Service de Pharmacologie Clinique, CHU Toulouse. pugnet.g@chu-toulouse.fr. 2. From the Faculté de Médecine, and the Laboratoire de Pharmacologie Médicale et Clinique, Université de Toulouse III; INSERM, UMR1027; Service de Médecine Interne, and the Service de Pharmacologie Clinique, Centre Hospitalier Universitaire (CHU) Toulouse; Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Service Médical Midi-Pyrénées, Toulouse, France.G. Pugnet, MD; L. Sailler, MD, PhD, Université de Toulouse III, INSERM, UMR1027, Service de Médecine Interne, CHU Toulouse; R. Bourrel, MD, Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Service Médical Midi-Pyrénées; J-L. Montastruc, MD, PhD; M. Lapeyre-Mestre, MD, PhD, Université de Toulouse III, INSERM, UMR1027, Laboratoire de Pharmacologie Médicale et Clinique, Université de Toulouse III, Service de Pharmacologie Clinique, CHU Toulouse.
Abstract
OBJECTIVE: To investigate the potential association between statin use and giant cell arteritis (GCA) course. METHODS: Using the French National Health Insurance system, we included patients with incident GCA from the Midi-Pyrenees region, southern France, from January 2005 to December 2008 and randomly selected 6 controls matched by age, sex, and date of diagnosis. Statin exposure was compared between patients with GCA and their controls before GCA occurrence with a logistic regression. Influence of statin exposure on prednisone requirements during GCA course was explored with a Cox model, considering statin exposure as a time-varying variable. RESULTS: The cohort included 103 patients (80 women, mean age 74.8 ± 9 yrs, mean followup 48.9 ± 14.8 mos), compared to 606 controls. Statin exposure (27.2% of patients with GCA and 23.4% of controls) was not associated with GCA occurrence (adjusted OR 1.2, 95% CI 0.76-1.96; p = 0.41). Diabetes mellitus was significantly associated to GCA occurrence (adjusted OR 0.38, 95% CI 0.11-0.72; p = 0.008). After diagnosis, exposure to statins up to 20 months was associated with maintenance while taking low prednisone doses (p = 0.01). CONCLUSION: Statin exposure was not associated with GCA occurrence in the general population. However, exposure to statins up to 20 months may favor a quicker corticosteroid tapering. Based on those results, statin effect on GCA course should not be definitively ruled out.
OBJECTIVE: To investigate the potential association between statin use and giant cell arteritis (GCA) course. METHODS: Using the French National Health Insurance system, we included patients with incident GCA from the Midi-Pyrenees region, southern France, from January 2005 to December 2008 and randomly selected 6 controls matched by age, sex, and date of diagnosis. Statin exposure was compared between patients with GCA and their controls before GCA occurrence with a logistic regression. Influence of statin exposure on prednisone requirements during GCA course was explored with a Cox model, considering statin exposure as a time-varying variable. RESULTS: The cohort included 103 patients (80 women, mean age 74.8 ± 9 yrs, mean followup 48.9 ± 14.8 mos), compared to 606 controls. Statin exposure (27.2% of patients with GCA and 23.4% of controls) was not associated with GCA occurrence (adjusted OR 1.2, 95% CI 0.76-1.96; p = 0.41). Diabetes mellitus was significantly associated to GCA occurrence (adjusted OR 0.38, 95% CI 0.11-0.72; p = 0.008). After diagnosis, exposure to statins up to 20 months was associated with maintenance while taking low prednisone doses (p = 0.01). CONCLUSION: Statin exposure was not associated with GCA occurrence in the general population. However, exposure to statins up to 20 months may favor a quicker corticosteroid tapering. Based on those results, statin effect on GCA course should not be definitively ruled out.
Authors: Sara Monti; Ana F Águeda; Raashid Ahmed Luqmani; Frank Buttgereit; Maria Cid; Christian Dejaco; Alfred Mahr; Cristina Ponte; Carlo Salvarani; Wolfgang Schmidt; Bernhard Hellmich Journal: RMD Open Date: 2019-09-16