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Association of Statin Use with Increased Risk of Musculoskeletal Conditions: A Retrospective Cohort Study

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Abstract

Introduction

Musculoskeletal conditions, including osteoarthritis (OA), result in tremendous disability and cost. Statins are among the most commonly prescribed medications and their use for primary prevention in many otherwise healthy individuals, including those who are physically active, is increasing. There is conflicting evidence regarding the relationship of statin use and musculoskeletal conditions. Given the rising disability associated with musculoskeletal conditions, understanding predisposing factors, including medication-related exposures, deserves further attention.

Objectives

We examined the association between statin use and the risk of being diagnosed with non-traumatic arthropathies, use-related injury, and undergoing rehabilitation in a cohort with longitudinal follow-up.

Methods

Patients enrolled in a regional military healthcare system between 2003 and 2012 were evaluated in this retrospective cohort study. A propensity score was generated to match statin-users and nonusers using 115 baseline characteristics. Outcomes included ICD-9 diagnoses codes for Agency for Healthcare Research and Quality disease categories of: non-traumatic arthropathies, use-related injury and undergoing rehabilitation. Primary analysis examined the outcomes in statin-users and nonusers after propensity score matching using conditional logistic regression analysis.

Results

Initially, 60,455 patients were identified. We propensity score-matched 6728 statin users with 6728 nonusers (52 years of age, ~ 47% women). In the propensity score-matched cohort, non-traumatic arthropathies occurred in 59.8% of statin users and 56.0% of nonusers [odds ratio (OR) 1.17, 95% confidence interval (95% CI) 1.09–1.25] and use related injury occurred in 31.9% of statin users and 29.8% of nonusers (OR 1.11, 95% CI 1.03–1.19). There was no difference between statin users and nonusers undergoing rehabilitation (22.6% among statin users, 21.9% among nonusers, OR 1.04, 95% CI 0.96–1.13).

Conclusion

Statin use was associated with a significant increased risk of non-traumatic arthropathies and use-related injury. Our results provide additional data that can inform patient and clinician conversations about the benefits and risks of statin use.

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Correspondence to Ishak A. Mansi.

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Funding

The research reported/outlined here was supported in part by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service and the Center for Patient-Centered Outcomes Research of the University of Texas Southwestern Center (R24 HS022418). Dr. Makris is a VA Health Services Research and Development Career Development awardee at the Dallas VA (IK2HX001916). Dr. Makris was supported in part by the UT Southwestern Center for Translational Medicine NIH/NCATS Grants (KL2TR001103 and UL1TR001105). Dr. Alvarez was supported in part by a grant from the National Institutes of Health (K08 DK101602). Dr. Mortensen was supported in part by a grant from the Agency for Healthcare Research and Quality (R24 HS022418) and the University of Texas Southwestern Center for Patient-Centered Outcomes Research.

Conflict of interest

Una E. Makris, Carlos A. Alvarez, Eric M. Mortensen, Ishak A. Mansi have no conflicts of interest that are directly relevant to the content of this study.

Ethical approval

Approval was obtained from the Institutional Review Board (IRB) at Brooke Army Medical Center and the VA North Texas Health System.

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Makris, U.E., Alvarez, C.A., Mortensen, E.M. et al. Association of Statin Use with Increased Risk of Musculoskeletal Conditions: A Retrospective Cohort Study. Drug Saf 41, 939–950 (2018). https://doi.org/10.1007/s40264-018-0682-y

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