WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: * The increasing evidence of the 
anti-inflammatory action of statins has stimulated interest in whether these 
might be beneficial in disease management of rheumatoid arthritis (RA), a 
chronic diseases characterized by high levels of inflammation. * The TARA trial 
(McCarey 2004) suggested a significant reduction in disease activity outcomes in 
RA patients randomized to atorvastatin compared with those assigned to the 
placebo harm. * However, as the signal reported by the trial was small, more 
evidence is needed.
WHAT THIS PAPER ADDS: * We investigated the possible anti-inflammatory effect of 
statins in a cohort of RA patients using a large health insurance claims 
database. * To our knowledge, this is the largest study ever conducted on the 
anti-inflammatory effects of statins. * Our data do not show any beneficial 
effect of statins in reducing disease inflammation in RA patients.
AIM: To investigate the possible anti-inflammatory effect of statins in a cohort 
of rheumatoid arthritis (RA) patients.
METHODS: We conducted a cohort study consisting of all patients with at least 
one claim for RA using LifeLink, a health insurance claims database. Initiation 
and cessation of oral steroid (OS) therapy were treated as surrogate for 
inflammatory flare-up and controlled inflammation, respectively. We split the RA 
patients into two sub-cohorts based on whether they were using OS within a 
specified time window of the RA index date (first recorded claim for RA in the 
database). Cox proportional hazard models were used to evaluate the association 
between time-varying exposure to any statins and (i) initiation of OS therapy in 
the non-users of OS at RA index date and (ii) cessation of OS therapy in the 
users of OS at RA index date controlling for potential confounders.
RESULTS: We found 31 451 non-users of OS at RA index date and 6026 users of OS 
within the time window at RA index date. The results on both sub-cohorts were 
both consistent with no association of statin exposure with the risk of 
initiation/cessation of OS: the hazard ratio (HR) of initiating OS therapy was 
0.96 (95% confidence interval 0.9, 1.01) in the sub-cohort of non-users and the 
HR of cessation of OS therapy was 0.95 (0.87, 1.05) in the sub-cohort of users 
of OS therapy at RA diagnosis.
CONCLUSIONS: These data do not show any beneficial effect of statins in reducing 
disease inflammation in RA patients.