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Is statin exposure associated with occurrence or better outcome in giant cell arteritis? Results from a French
Grégory Pugnet1, Laurent Sailler2, Robert Bourrel2
1From 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.
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.
