title: Is statin exposure associated with occurrence or better outcome in giant cell arteritis? Results from a French population-based study.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: From 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.
authors.forename: Grégory
authors.initials: G
authors.lastname: Pugnet
authors.affiliation: From 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.
authors.forename: Laurent
authors.initials: L
authors.lastname: Sailler
authors.affiliation: From 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.
authors.forename: Robert
authors.initials: R
authors.lastname: Bourrel
authors.affiliation: From 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.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Montastruc
authors.affiliation: From 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.
authors.forename: Maryse
authors.initials: M
authors.lastname: Lapeyre-Mestre
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D005260:Female; D005602:France; D013700:Giant Cell Arteritis / Q000150:complications / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use*; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011241:Prednisone
keywords: GIANT CELL ARTERITIS; PREDNISONE; STATINS