Use of lipid-lowering agents in rheumatoid arthritis

A population-based cohort study

Bharath Manu Akkara Veetil, Elena Myasoedova, Eric Lawrence Matteson, Sherine E. Gabriel, Cynthia Crowson

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objective. Rheumatoid arthritis (RA) is associated with an increased risk of cardiovascular disease and mortality. Lipid-lowering therapy is reportedly underused in patients with RA. Longitudinal cohort studies comparing use of lipid-lowering medications in patients with RA versus the general population are lacking. Methods. Cardiovascular risk factors, lipid measures, and use of lipid-lowering agents were assessed in a population-based inception cohort of patients with RA and a cohort of non-RA subjects followed from January 1, 1988, to December 31, 2008. The National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATPIII) guidelines were assessed at the time of each lipid measure throughout followup. Time from meeting guidelines to initiation of lipid-lowering agents was assessed using Kaplan-Meier methods. Results. The study population included 412 RA and 438 non-RA patients with = 1 lipid measure during followup and no prior use of lipid-lowering agents. Rates of lipid testing were lower among patients with RA compared to non-RA subjects. Among patients who met NCEP ATPIII criteria for lipid-lowering therapy (n = 106 RA; n = 120 non-RA), only 27% of RA and 26% of non-RA subjects initiated lipid-lowering agents within 2 years of meeting the guidelines for initiation. Conclusion. There was substantial undertreatment in both the RA and the non-RA cohorts who met NCEP ATPIII criteria for initiation of lipid-lowering agents. Patients with RA did not have as frequent lipid testing as individuals in the general population.

Original languageEnglish (US)
Pages (from-to)1082-1088
Number of pages7
JournalJournal of Rheumatology
Volume40
Issue number7
DOIs
StatePublished - Jul 2013

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Rheumatoid Arthritis
Cohort Studies
Lipids
Population
Arthritis
Cholesterol
Guidelines
Education
Therapeutics
Longitudinal Studies
Cardiovascular Diseases
Mortality

Keywords

  • Lipid-Lowering Therapy
  • Lipids
  • Rheumatoid Arthritis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy

Cite this

Use of lipid-lowering agents in rheumatoid arthritis : A population-based cohort study. / Veetil, Bharath Manu Akkara; Myasoedova, Elena; Matteson, Eric Lawrence; Gabriel, Sherine E.; Crowson, Cynthia.

In: Journal of Rheumatology, Vol. 40, No. 7, 07.2013, p. 1082-1088.

Research output: Contribution to journalArticle

Veetil, Bharath Manu Akkara ; Myasoedova, Elena ; Matteson, Eric Lawrence ; Gabriel, Sherine E. ; Crowson, Cynthia. / Use of lipid-lowering agents in rheumatoid arthritis : A population-based cohort study. In: Journal of Rheumatology. 2013 ; Vol. 40, No. 7. pp. 1082-1088.
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abstract = "Objective. Rheumatoid arthritis (RA) is associated with an increased risk of cardiovascular disease and mortality. Lipid-lowering therapy is reportedly underused in patients with RA. Longitudinal cohort studies comparing use of lipid-lowering medications in patients with RA versus the general population are lacking. Methods. Cardiovascular risk factors, lipid measures, and use of lipid-lowering agents were assessed in a population-based inception cohort of patients with RA and a cohort of non-RA subjects followed from January 1, 1988, to December 31, 2008. The National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATPIII) guidelines were assessed at the time of each lipid measure throughout followup. Time from meeting guidelines to initiation of lipid-lowering agents was assessed using Kaplan-Meier methods. Results. The study population included 412 RA and 438 non-RA patients with = 1 lipid measure during followup and no prior use of lipid-lowering agents. Rates of lipid testing were lower among patients with RA compared to non-RA subjects. Among patients who met NCEP ATPIII criteria for lipid-lowering therapy (n = 106 RA; n = 120 non-RA), only 27{\%} of RA and 26{\%} of non-RA subjects initiated lipid-lowering agents within 2 years of meeting the guidelines for initiation. Conclusion. There was substantial undertreatment in both the RA and the non-RA cohorts who met NCEP ATPIII criteria for initiation of lipid-lowering agents. Patients with RA did not have as frequent lipid testing as individuals in the general population.",
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