title: Use of lipid-lowering agents in rheumatoid arthritis: a population-based cohort study.
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.
  
  
  CONCLUSIONS
  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.
authors: Division of Rheumatology and Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors: Bharath Manu
authors: BM
authors: Akkara Veetil
authors: Elena
authors: E
authors: Myasoedova
authors: Eric L
authors: EL
authors: Matteson
authors: Sherine E
authors: SE
authors: Gabriel
authors: Cynthia S
authors: CS
authors: Crowson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications*; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control*; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D000960:Hypolipidemic Agents; D008055:Lipids
keywords: LIPID-LOWERING THERAPY; LIPIDS; RHEUMATOID ARTHRITIS
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