Atorvastatin has No Beneficial Effect For Patients With Knee Osteoarthritis, Claims Study
Inflammation plays a pivotal role in the development and progression of knee osteoarthritis (OA), the most common form of osteoarthritis worldwide. It was reported that statins have multiple effects on inflammation at cellular and extra-cellular level, including a reduction in inflammatory cytokines and T cell activation. However, in a recent study, researchers have reported that atorvastatin does not significantly reduce cartilage volume loss over two years in patients with symptomatic knee osteoarthritis. The study findings were published in the journal Arthritis & Rheumatology on April 12, 2021.
Statins have several pleiotropic effects, but the literature regarding the possible relationship between statins use and outcomes in knee osteoarthritis (OA) is limited. Therefore, researchers of Monash University, Australia, conducted a study to determine whether atorvastatin compared to placebo slows tibial cartilage volume loss in patients with symptomatic knee osteoarthritis. It was a multicentre, randomised, double‐blind, placebo‐controlled trial of 304 participants with knee osteoarthritis. Researchers randomly assigned the patients to either oral atorvastatin 40 mg (n=151) or matching placebo (n=153) once daily. The major outcome assessed was the annual percentage change in tibial cartilage volume assessed using magnetic resonance imaging (MRI) over two years. The researchers also evaluated the progression of cartilage defects and bone marrow lesions assessed using MRI and change in Western Ontario and McMaster Universities Osteoarthritis Index pain, stiffness and function over two years.
Key findings of the study were:
- Upon analysis, the researchers found that annual change in tibial cartilage volume differed minimally between the atorvastatin and placebo groups (‐1.66% vs ‐2.17%, difference 0.50%).
- They also found no significant differences in
◊ Progression of cartilage defects (odds ratio 0.86) or
◊ Bone marrow lesions (odds ratio 1.00),
◊ Change in pain (‐36.0 vs ‐29.5, adjusted difference ‐2.7),
◊ Stiffness (‐14.2 vs ‐11.8, adjusted difference ‐0.2), or
◊ Function (‐89.4 vs ‐87.5, adjusted difference 0.3).
- They reported similar incidence of adverse events in atorvastatin (n=57, 37.7%) and placebo (n=52, 34.0%) groups.
The authors concluded, "Oral atorvastatin 40 mg once daily, compared with placebo, did not significantly reduce cartilage volume loss over two years in patients with symptomatic knee osteoarthritis. These findings do not support use of atorvastatin in the treatment of knee osteoarthritis."
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