Survival benefit of statin use in ankylosing spondylitis: a general population-based cohort study

Oza, A.; Lu, Na; Schoenfeld, Sara R.; Fisher, Mark; Dubreuil, Maureen; Sharan, K.; Zhang, Yuqing; Choi, Hyon K.

doi:10.1136/annrheumdis-2017-211253

Cited by 32 publications

(17 citation statements)

References 26 publications

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“…Multiple preclinical and clinical studies have analysed the impact of different statins on RA . Statins are given to patients with RA because of their increased risk for cardiovascular complications .…”

Section: Statins In Ramentioning

confidence: 99%

“…Multiple preclinical and clinical studies have analysed the impact of different statins on RA. [21][22][23] Statins are given to patients with RA because of their increased risk for cardiovascular complications. 24 A cohort study that included patients with a diagnosis of hyperlipidaemia who started statin intake showed that the connection between lowering low-density lipoprotein cholesterol and cardiovascular events in RA was comparable to the association found in matched general controls.…”

Section: Statins In Ramentioning

confidence: 99%

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Immune modulatory effects of statins

2018

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SummaryDespite major advances in recent years, immunosuppressive regimens for multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus and graft-versus-host disease still have major adverse effects and immunomodulation rather than immune paralysis would be desirable. Statins inhibit the rate-limiting enzyme of the L-mevalonate pathway, the 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase. It was shown that blocking the L-mevalonate pathway reduces inflammation through effects on downstream metabolites of the pathway including farnesylpyrophosphates and geranylgeranylpyrophosphates, which are essential for the attachment of GTPases like RhoA, Rac and Ras to the cell membrane. Therefore, Lmevalonate pathway downstream products play critical roles in the different steps of an immune response including immune cell activation, migration, cytokine production, immune metabolism and survival. This review discusses the relevance of the different metabolites for the immunomodulatory effect of statins and connects preclinical results with data from clinical studies that tested statins for the treatment of different inflammatory diseases.

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Section: Statins In Ramentioning

confidence: 99%

Section: Statins In Ramentioning

confidence: 99%

Immune modulatory effects of statins

2018

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“…In our study, the RR demonstrated being superior to the SCORE risk function to identify high CV risk AS patients under 50 years, thus allowing them to benefit from an intensive preventive therapy. This is a crucial aspect considering that statins have been shown to decrease mortality by 37% in AS, a figure that doubles that observed in the general population [12]. …”

Section: Discussionmentioning

confidence: 99%

Relative Risk Chart Score for the Assessment of the Cardiovascular Risk in Young Patients with Ankylosing Spondylitis

Rueda-Gotor

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Corrales

et al. 2018

International Journal of Rheumatology

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Objective To determine if the use of the relative risk (RR) chart score may help to identify young ankylosing spondylitis (AS) patients at high risk of cardiovascular (CV) disease. Methods 73 AS patients younger than 50 years were assessed. CV risk was calculated according to the total cholesterol systematic coronary risk evaluation (TC-SCORE) and the RR chart score. C-reactive protein (CRP) value at disease diagnosis and carotid ultrasound data were also analyzed. Results Twenty (27.4%) patients exhibited carotid plaques being classified into the category of very high CV risk. None of them was found to have a high/very high TC-SCORE. CRP > 3 mg/L at disease diagnosis was associated with the presence of carotid plaques (odds ratio 5.66, p = 0.03). Whereas only 5 (14.2%) of the 35 patients with RR = 1 had carotid plaques, 15 (39.5%) of 38 with RR > 1 showed plaques. A model that included the performance of carotid US in patients with RR > 1 who had CRP > 3 mg/L allowed us to identify 60% of very high risk patients, with a specificity of 77.4%. Conclusions RR chart score assessment may help to identify young AS patients at high risk of CV disease.

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“…Taking into account these considerations, we can conclude that almost 50% of AS included in the categories of low and moderate CV risk according to the TC-SCORE risk algorithm would benefit from additional primary prevention measures, with special emphasis on the use of statins, if a plain lateral lumbar spine radiography is performed. This is a crucial aspect considering that statins have been shown to decrease mortality by 37% in AS, a figure double that observed in the general population [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…In this regard, statin use has proved to be very effective, being able to reduce overall mortality by 15% [ 7 ]. The benefit may be even greater in AS patients according to a recent study which found a 37% lower risk of all-cause mortality associated with statin initiation [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Detection of high cardiovascular risk patients with ankylosing spondylitis based on the assessment of abdominal aortic calcium as compared to carotid ultrasound

et al. 2018

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BackgroundThis study aimed to determine whether, besides carotid ultrasound (US), a lateral lumbar spine radiography may also help identify ankylosing spondylitis (AS) patients at high risk of cardiovascular (CV) disease.MethodsA set of 125 AS patients older than 35 years without a history of CV events, diabetes mellitus, or chronic kidney disease was recruited. Carotid US and lateral lumbar spine radiography were performed in all of them. The CV risk was calculated according to the total cholesterol systematic coronary risk evaluation (TC-SCORE) algorithm. Presence of carotid plaques was defined following the Mannheim Carotid Intima-media Thickness and Plaque Consensus. Abdominal aortic calcium (AAC) in a plain radiography was defined as calcific densities visible in an area parallel and anterior to the lumbar spine.ResultsCarotid US showed higher sensitivity than lateral lumbar spine radiography to detect high CV risk in the 54 patients with moderate TC-SCORE (61% versus 38.9%). Using carotid plaques as the gold standard test, a predictive model that included a TC-SCORE ≥ 5% or the presence of AAC in the lateral lumbar spine radiography in patients with both moderate and low CV risk (< 5%) according to the TC-SCORE yielded a sensitivity of 50.9% with a specificity of 95.7% to identify high/very high CV-risk AS patients. A positive correlation between AAC and carotid plaques was observed (r2 = 0.49, p < 0.001).ConclusionsA lateral lumbar spine radiography is a useful tool to identify patients with AS at high risk of CV disease.

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Survival benefit of statin use in ankylosing spondylitis: a general population-based cohort study

Cited by 32 publications

References 26 publications

Immune modulatory effects of statins

Immune modulatory effects of statins

Relative Risk Chart Score for the Assessment of the Cardiovascular Risk in Young Patients with Ankylosing Spondylitis

Detection of high cardiovascular risk patients with ankylosing spondylitis based on the assessment of abdominal aortic calcium as compared to carotid ultrasound

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