Rheumatoid Arthritis Patients Who Quit Statins May Face Raised Death Risk

Cardiovascular disease very common among these patients, experts note

Wednesday, March 28, 2012

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WEDNESDAY, March 28 (HealthDay News) -- People suffering from rheumatoid arthritis who stop taking their cholesterol-lowering drugs may raise their risk of dying, a new study finds.
In fact, those who stopped taking statins raised their chances of dying from cardiovascular disease by 60 percent and dying from any cause by 79 percent during the course of the study, the Canadian researchers reported.
Since rheumatoid arthritis is associated with an increased risk of cardiovascular disease, patients often are prescribed statins such as Lipitor (atorvastatin) or Crestor (rosuvastatin) to lower their cholesterol.
"Doctor knows best," said Dr. Richard Furie, chief of the division of rheumatology at North Shore-LIJ Health System in Lake Success, N.Y. "Whatever medicines your doctor puts you on, take them all."
"We know that in inflammatory diseases such as rheumatoid arthritis, cardiovascular events are a significant problem and are the leading cause of death," he added.
The report was published in the March 28 online edition of the journal Arthritis Care & Research.
For the study, a team led by Mary De Vera, from the School of Population & Public Health at the University of British Columbia in Vancouver, used records from the British Columbia Ministry of Health to collect data on more than 37,000 rheumatoid arthritis patients.
Among these patients, more than 4,000 were taking statins. During the four years the researchers studied, however, about 45 percent stopped using the drugs for three months or more.
Of these patients, 198 died from cardiovascular disease -- 31 percent from heart attack and 15 percent from stroke, the researchers found. In all, 467 of the patients died from all causes.
The World Health Organization estimates that 1 percent of people in developed countries suffer from rheumatoid arthritis. Death rates among people with rheumatoid arthritis are 1.5 times higher than in the general population, with cardiovascular disease the leading cause of death, the researchers noted.
Stopping use of statins, however, might be only part of the reason for the increased risk of dying seen during the study, Furie said.
"Why is someone a bad patient?" he asked. "If they are a bad patient in adherence to medicines, they may be a bad patient in adherence to diet, exercise, smoking and a whole bunch of other things."
Adherence to medication is a big problem in general, Furie said. Another reason people may stop taking statins or blood-pressure medication is that they don't feel any different and don't see any effect.
Short of watching patients take their medications, he said, the question is, how can doctors make sure patients take them?
"You try to scare them," Furie said. "Some people scare and some people don't. The doctor knows best; take your pills."

SOURCES: Richard Furie, M.D., chief, division of rheumatology, North Shore-LIJ Health System, Lake Success, N.Y.; March 28, 2012, Arthritis Care & Research, online

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