FRI0560 INCREASED RISK OF RHEUMATOID ARTHRITIS DIAGNOSIS IN STATIN USERS IN A LARGE NATIONWIDE US STUDY

Abstract

Background:Studies evaluating the effect of statin use on the risk of rheumatoid arthritis (RA) onset have shown conflicting results. Most of these studies evaluated European populations while data from the US are scarce.Objectives:We aimed to assess the association between statin use (and intensity) and RA occurrence using claims data from the US population.Methods:For this case-control study, we used the OptumLabs Data Warehouse, a large administrative database of commercially insured and Medicare Advantage beneficiaries, to identify cases of RA and matched controls. Cases were defined as patients with 2 or more diagnoses of RA in January 1, 2010 - June 30, 2019 who were ≥18 years old, filled ≥1 prescription for a conventional or biologic disease modifying anti-rheumatic drug, and had no diagnoses of RA during the prior year. Controls were persons without RA matched 1:1 to RA cases on age, sex, census region, calendar year of index date (corresponding to the date of second diagnosis code for RA), and length of prior medical/pharmacy coverage. Statin use was defined as any filled prescription for a statin medication during prior coverage (excluding any new statin prescriptions filled up to 90 days before first RA diagnosis or index date). Logistic regression models were used to estimate odds ratios (OR)with 95% confidence intervals (CI) adjusted for age, sex, race, census region, calendar year and Charlson comorbidity index (excluding RA component).Results:The study included 32,465 cases with RA (mean age 57.0, 72.2% female) and 32,465 matched controls (mean age 57.0, 72.2% female). There were 10,759 (33.1%) statin users among RA patients and 4,016 (12.4%) statin users among the matched controls. Statin use was associated with increased risk of RA (adjusted OR 3.34, 95%CI 3.19-3.49). All levels of statin intensity were associated with increased risk of RA (high OR: 3.60, 95% CI 3.28-3.94; medium OR: 3.20, 95% CI 3.04-3.37; low OR: 3.72, 95% CI 3.34-4.15) compared to non-users. Both former and current statin users showed an increased risk of RA (current OR: 3.04, 95% CI 2.80-3.30 and former OR: 3.37, 95% CI 3.20-3.54) compared to non-users.Conclusion:This large nationwide study showed increased risk of RA in statin-users vs non-users. The lack of dose dependence may suggest confounding by indication or a common genetic predisposition for cardiovascular disease and RA. The underlying mechanisms for these associations require further investigation.Disclosure of Interests:Madeline Peterson: None declared, Hayley J. Dykhoff: None declared, Cynthia S. Crowson Grant/research support from: Pfizer research grant, John M Davis III Grant/research support from: Research grants from Pfizer, Consultant of: Served on advisory boards for Abbvie and Sanofi-Genzyme, Lindsey Sangaralingham: None declared, Elena Myasoedova: None declared