title: Cardiovascular Outcomes Associated with Lowering Low-density Lipoprotein Cholesterol in Rheumatoid Arthritis and Matched Nonrheumatoid Arthritis.
abstract: To examine the associations between lowering low-density lipoprotein cholesterol (LDL-C) and cardiovascular (CV) outcomes among patients with rheumatoid arthritis (RA) and patients without it.
  
  
  
  Adult patients with RA and 2 age- and sex-matched control cohorts [RA plus general controls (RA/GN), RA plus osteoarthritis (OA) controls (RA/OA)] were identified between January 1, 2007, and December 31, 2011. Patients with a diagnosis of hyperlipidemia who initiated statin therapy without prior CV events were included. Multivariable Cox proportional hazard analyses were used.
  
  
  
  The study identified 1522 patients with RA with 6511 general controls (RA/GN cohort); and 1746 patients with RA with 2554 OA controls (RA/OA cohort). During followup, mean (SD) LDL-C (mg/dl) was 96.8 (32.7) for RA, 100.1 (35.1) for general controls, and 99.1 (34.3) for OA. The relationship between lowering LDL-C and CV outcomes was similar for both RA and non-RA controls (p for interaction = 0.852 in RA/GN cohort, and p = 0.610 in RA/OA cohort). After adjusting for baseline CV risk factors, lowering LDL-C was associated with a 29%-50% lower risk of CV events (HR [95% CI] = 0.71 [0.57-0.89] in RA/GN, 0.50 [0.43-0.58] in RA/OA). Subgroup analyses showed that lowering LDL-C was associated with a similar degree of reduction of CV events in RA and non-RA controls (HR of 0.67-0.68 for RA, 0.72 for general controls, 0.76 for OA controls).
  
  
  
  Lowering LDL-C levels was associated with reduced CV events. The relationship between lowering LDL-C and CV outcomes in RA was similar to the relationship found in matched general and OA controls.
authors: From the Department of Pharmacy Practice and Administration, Western University of Health Sciences, Pomona, California; Bristol-Myers Squibb, Princeton, New Jersey; Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California; Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Drug Information Services, Kaiser Permanente Southern California, Downey, California, USA. jan@westernu.edu.|J. An, BPharm, PhD, Department of Pharmacy Practice and Administration, Western University of Health Sciences; E. Alemao, RPh, MS, Bristol-Myers Squibb; K. Reynolds, PhD, MPH, Research and Evaluation, Kaiser Permanente Southern California; H. Kawabata, MS, Bristol-Myers Squibb; D.H. Solomon, MD, MPH, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School; K.P. Liao, MD, MPH, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School; F. Niu, MS, Drug Information Services, Kaiser Permanente Southern California; T.C. Cheetham, PharmD, MS, Research and Evaluation, Kaiser Permanente Southern California. jan@westernu.edu.
authors: JaeJin
authors: J
authors: An
authors: From the Department of Pharmacy Practice and Administration, Western University of Health Sciences, Pomona, California; Bristol-Myers Squibb, Princeton, New Jersey; Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California; Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Drug Information Services, Kaiser Permanente Southern California, Downey, California, USA.|J. An, BPharm, PhD, Department of Pharmacy Practice and Administration, Western University of Health Sciences; E. Alemao, RPh, MS, Bristol-Myers Squibb; K. Reynolds, PhD, MPH, Research and Evaluation, Kaiser Permanente Southern California; H. Kawabata, MS, Bristol-Myers Squibb; D.H. Solomon, MD, MPH, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School; K.P. Liao, MD, MPH, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School; F. Niu, MS, Drug Information Services, Kaiser Permanente Southern California; T.C. Cheetham, PharmD, MS, Research and Evaluation, Kaiser Permanente Southern California.
authors: Evo
authors: E
authors: Alemao
authors: From the Department of Pharmacy Practice and Administration, Western University of Health Sciences, Pomona, California; Bristol-Myers Squibb, Princeton, New Jersey; Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California; Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Drug Information Services, Kaiser Permanente Southern California, Downey, California, USA.|J. An, BPharm, PhD, Department of Pharmacy Practice and Administration, Western University of Health Sciences; E. Alemao, RPh, MS, Bristol-Myers Squibb; K. Reynolds, PhD, MPH, Research and Evaluation, Kaiser Permanente Southern California; H. Kawabata, MS, Bristol-Myers Squibb; D.H. Solomon, MD, MPH, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School; K.P. Liao, MD, MPH, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School; F. Niu, MS, Drug Information Services, Kaiser Permanente Southern California; T.C. Cheetham, PharmD, MS, Research and Evaluation, Kaiser Permanente Southern California.
authors: Kristi
authors: K
authors: Reynolds
authors: From the Department of Pharmacy Practice and Administration, Western University of Health Sciences, Pomona, California; Bristol-Myers Squibb, Princeton, New Jersey; Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California; Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Drug Information Services, Kaiser Permanente Southern California, Downey, California, USA.|J. An, BPharm, PhD, Department of Pharmacy Practice and Administration, Western University of Health Sciences; E. Alemao, RPh, MS, Bristol-Myers Squibb; K. Reynolds, PhD, MPH, Research and Evaluation, Kaiser Permanente Southern California; H. Kawabata, MS, Bristol-Myers Squibb; D.H. Solomon, MD, MPH, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School; K.P. Liao, MD, MPH, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School; F. Niu, MS, Drug Information Services, Kaiser Permanente Southern California; T.C. Cheetham, PharmD, MS, Research and Evaluation, Kaiser Permanente Southern California.
authors: Hugh
authors: H
authors: Kawabata
authors: From the Department of Pharmacy Practice and Administration, Western University of Health Sciences, Pomona, California; Bristol-Myers Squibb, Princeton, New Jersey; Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California; Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Drug Information Services, Kaiser Permanente Southern California, Downey, California, USA.|J. An, BPharm, PhD, Department of Pharmacy Practice and Administration, Western University of Health Sciences; E. Alemao, RPh, MS, Bristol-Myers Squibb; K. Reynolds, PhD, MPH, Research and Evaluation, Kaiser Permanente Southern California; H. Kawabata, MS, Bristol-Myers Squibb; D.H. Solomon, MD, MPH, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School; K.P. Liao, MD, MPH, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School; F. Niu, MS, Drug Information Services, Kaiser Permanente Southern California; T.C. Cheetham, PharmD, MS, Research and Evaluation, Kaiser Permanente Southern California.
authors: Daniel H
authors: DH
authors: Solomon
authors: From the Department of Pharmacy Practice and Administration, Western University of Health Sciences, Pomona, California; Bristol-Myers Squibb, Princeton, New Jersey; Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California; Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Drug Information Services, Kaiser Permanente Southern California, Downey, California, USA.|J. An, BPharm, PhD, Department of Pharmacy Practice and Administration, Western University of Health Sciences; E. Alemao, RPh, MS, Bristol-Myers Squibb; K. Reynolds, PhD, MPH, Research and Evaluation, Kaiser Permanente Southern California; H. Kawabata, MS, Bristol-Myers Squibb; D.H. Solomon, MD, MPH, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School; K.P. Liao, MD, MPH, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School; F. Niu, MS, Drug Information Services, Kaiser Permanente Southern California; T.C. Cheetham, PharmD, MS, Research and Evaluation, Kaiser Permanente Southern California.
authors: Katherine P
authors: KP
authors: Liao
authors: From the Department of Pharmacy Practice and Administration, Western University of Health Sciences, Pomona, California; Bristol-Myers Squibb, Princeton, New Jersey; Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California; Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Drug Information Services, Kaiser Permanente Southern California, Downey, California, USA.|J. An, BPharm, PhD, Department of Pharmacy Practice and Administration, Western University of Health Sciences; E. Alemao, RPh, MS, Bristol-Myers Squibb; K. Reynolds, PhD, MPH, Research and Evaluation, Kaiser Permanente Southern California; H. Kawabata, MS, Bristol-Myers Squibb; D.H. Solomon, MD, MPH, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School; K.P. Liao, MD, MPH, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School; F. Niu, MS, Drug Information Services, Kaiser Permanente Southern California; T.C. Cheetham, PharmD, MS, Research and Evaluation, Kaiser Permanente Southern California.
authors: Fang
authors: F
authors: Niu
authors: From the Department of Pharmacy Practice and Administration, Western University of Health Sciences, Pomona, California; Bristol-Myers Squibb, Princeton, New Jersey; Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California; Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Drug Information Services, Kaiser Permanente Southern California, Downey, California, USA.|J. An, BPharm, PhD, Department of Pharmacy Practice and Administration, Western University of Health Sciences; E. Alemao, RPh, MS, Bristol-Myers Squibb; K. Reynolds, PhD, MPH, Research and Evaluation, Kaiser Permanente Southern California; H. Kawabata, MS, Bristol-Myers Squibb; D.H. Solomon, MD, MPH, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School; K.P. Liao, MD, MPH, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School; F. Niu, MS, Drug Information Services, Kaiser Permanente Southern California; T.C. Cheetham, PharmD, MS, Research and Evaluation, Kaiser Permanente Southern California.
authors: T Craig
authors: TC
authors: Cheetham
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000150:complications; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000097:blood / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: CARDIOVASCULAR DISEASES; CHOLESTEROL; LOW-DENSITY LIPOPROTEIN; RHEUMATOID ARTHRITIS