Dataset Information

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

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.

SUBMITTER: Makris UE

PROVIDER: S-EPMC6143406 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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

Makris Una E UE Alvarez Carlos A CA Mortensen Eric M EM Mansi Ishak A IA

Drug safety 20181001 10

<h4>Introduction</h4>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, understand ...[more]

PMID: 29797239

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Project description:BackgroundThe validity of cardiovascular disease (CVD) risk calculators in decision for statin therapy has not been fully evaluated at a population level. This study aimed to examine the net benefits of statins according to predicted CVD risk.Methods and findingsA cohort of 40 to 79-year-old Korean adults without CVD was generated from the National Health Information Database 2006-2017. Major CVD event rates and all-cause mortality in 58,265 users who initiated statins during 2007-2010 were compared with those in 58,265 nonusers matched on propensity scores, from January 1, 2012 through December 31, 2017. Additionally, simulation was performed for the population-based cohort of 659,759 adults. CVD risk was predicted using the 2018 revised Pooled Cohort Equations. In propensity score-matched cohort, the CVD hazard ratios (95% CIs) in occasional, intermittent, and regular statin users were 1.06 (0.93-1.20), 0.82 (0.70-0.97), and 0.57 (0.50-0.64), respectively. The corresponding mortality hazard ratios were 1.01 (0.92-1.10), 0.87 (0.78-0.98), and 0.71 (0.66-0.77), respectively. In stratified analyses, the relative risk reductions were similar, irrespective of age, sex, or predicted CVD risk. Accordingly, absolute risk reductions were greater in higher risk categories. In 6-year follow-up simulation cohorts, regular statin use could reduce 17 CVDs and 28 deaths in 1000 adults with a 10-year risk of ≥10.0% vs 10 CVDs and 14 deaths in 1000 with ≥2 major risk factors. However, in actual adults with a risk of ≥10%, statin use was insufficient and estimated to reduce 3 CVDs and 4 deaths in 1000. Limitations of this study include assessment of medication use based on the prescription data, lack of information on the intensity of statins, and limited generalizability to individuals with very old age or other ethnicity.ConclusionsCVD risk calculators were valid in decision-making for primary prevention statin therapy. Proper risk assessment and regular statin use in patients at high predicted risk would reduce outcome risks much more than present in Asian populations.

Project description:PurposePrevious studies have suggested that cholesterol may influence thyroid function. Since statins are widely used for their cholesterol-lowering effect, we aimed to assess the association between statin use and thyroid function, and also to explore the role of the cholesterol-lowering effect in it.MethodsWe performed a retrospective cohort study derived from REACTION study. Eligible subjects receiving statin therapy were included in the statin group, and sex-, age-, total cholesterol (TC)-, and thyroid function-matched participants without lipid-lowering therapy were included in the control group. The median follow-up time was three years. Outcomes of thyroid function were evaluated at the end of follow-up. We used multivariable regression models to assess the association between statin use and outcomes of thyroid function, and also performed mediation analyses to explore the role of cholesterol in it.ResultsA total of 5,146 participants were screened, and 201 eligible subjects in the statin group and 201 well-matched subjects in the control group were analyzed. At the end of follow-up, TC and thyroid-stimulating hormone (TSH) levels in the statin group were lower than those in the control group (both p < 0.05), and the percentage of euthyroid subjects was higher in the statin group (88.06% vs. 76.12%, p = 0.002). The incidence rate of subclinical hypothyroidism (SCH) in euthyroid subjects was lower in the statin group (6.29% vs. 14.86%, p = 0.009), and the remission rate among subjects with SCH was higher in the statin group (50.00% vs. 15.38%, p = 0.008). In multivariable regression analyses, statin use was independently associated with lower TSH levels and higher odds to be euthyroid (OR 2.335, p = 0.004) at the end of follow-up. Mediation analyses showed the association between statin use and TSH levels were mediated by TC changes during follow-up.ConclusionStatin use was associated with benefits of thyroid function, and TC changes serve as a mediator of the association between statin use and TSH levels. Further studies are needed to clarify the possible underlying mechanism.

Project description:Introduction: MicroRNAs (miRNAs) are small, non-coding RNA molecules involved in post-transcriptional gene regulation and have recently been shown to play a role in cancer metastasis. In solid tumors, especially breast cancer, alterations in miRNA expression contribute to cancer pathogenesis, including metastasis. Considering the emerging role of miRNAs in metastasis, the identification of predictive markers is necessary to further understanding of stage-specific breast cancer development. This is a retrospective analysis that aimed to identify molecular biomarkers related to distant breast cancer metastasis development.<br><br>Methods: A retrospective case cohort study was performed in 64 breast cancer patients treated during the period from 1998-2001. The case group (n=29) consisted of patients with a poor prognosis who presented with breast cancer recurrence or metastasis during follow up. The control group (n=35) consisted of a random sample of patients with a good prognosis who did not develop breast cancer recurrence or metastasis. These patient groups were stratified according to TNM clinical stage (CS) I, II and III, and the main clinical features of the patients were homogeneous. miRNA profiling was performed using formalin-fixed, paraffin-embedded tumors. Biomarkers related to metastatic potential were identified independent of clinical stage, and a cutoff point was selected based on the optimal sensitivity and specificity (ROC curve). Finally, a hazard risk analysis of these biomarkers was performed to evaluate their relation to metastatic potential. <br><br>Results: miRNA expression profiling identified several miRNAs that were either specific and shared across all clinical stages (p?0.05). Among these, we identified miRNAs previously associated with cell motility (let-7 family), cell proliferation and invasion (hsa-miR-16 and has-miR-205) and distant metastasis (hsa-miR-21). In addition, hsa-miR-494 and hsa-miR-21 were up-regulated in metastatic cases of CSI and II. Furthermore, the combination of the 3 miRNAs identified for CSII (hsa-miR-494, hsa-miR-183 and hsa-miR-21) was significant and were a more effective risk marker compared to the single miRNAs. <br><br>Conclusions: Women with metastatic breast cancer, especially CSII, presented up-regulated levels of miR-183, miR-494 and miR-21, which were associated with a poor prognosis. These miRNAs therefore represent new risk biomarkers of breast cancer metastasis and may be useful for future targeted therapies.

Dataset Information

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

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

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