Recent research shows that statins — the drugs people take to lower their cholesterol — may also lower their chances of getting osteoarthritis or delay its progression.
Traditionally, treatment for osteoarthritis (OA) has been limited to relieving symptoms and replacing joints with prostheses once they become irreparably damaged. However, researchers are actively looking for treatments that will not only ease OA’s pain and stiffness, but will slow, stop – or even prevent – the progression of joint damage. Statins may be one possible answer.
Proof That Statins May Work Against OA
Several studies have found that all other things being equal (age, weight, comorbid conditions, for example) people taking statins either had a lower prevalence of OA or had slower-progressing OA than those who didn’t take the drugs.
In a study of more than 3,000 people with severe OA, researchers from University of Nottingham in the United Kingdom found that statin use was associated with a lower prevalence of the nodal type of generalized osteoarthritis (OA in three or more joints, specifically characterized by Heberden’s and Bouchard’s nodes on the fingers); however, they found no such lowered prevalence of hip or knee OA. Results were published in 2014 in Annals of the Rheumatic Diseases.
Researchers at Keele University in the United Kingdom looked at statin use and OA among more than 16,000 adults; the results were published in 2013 in Journal of General Internal Medicine. They found that those taking the highest doses of statins – 18.5 mg or more daily – were 60% less likely to have osteoarthritis than those not taking statins.
In a study published in 2012 in Annals of the Rheumatic Diseases, researchers at the Erasmus Medical Centre in Rotterdam, The Netherlands, found that taking statins may help delay the progression of knee OA. Researchers obtained X-rays of 2,921 participants’ knees and hips at baseline and again 6.5 years later to look for signs of osteoarthritis. They found that, the knees of OA patients who took statins had 50% less OA progression than the knees of those who didn’t take statins.
Could Statins Have Bad Effects on OA?
A few studies, however, have not shown an association between statin use and reduced OA progression. In fact, in some studies statin use was associated with increased incidence of or worsening of OA.
In a study published in 2012 in the Annals of the Rheumatic Diseases, researchers at Virginia Commonwealth University, Richmond, examined changes in several commonly used disease measures in 2,207 people with X-ray evidence of OA. Their only significant finding indicated that longer use of statins was associated with a worsening of physical function scores over the 4-year study period.
In a separate study of 5,674 elderly women, researchers at the University of California, San Francisco found statin use was associated with increased odds of developing significant X-ray evidence of OA in the hip. They did find, however, a slight trend toward decreased progression of hip OA in statin users. The study was published in 2005 in the Journal of Rheumatology.
How Might Statins Work to Combat OA?
Right now researchers can’t say for certain statins will protect against OA progression. Although study results have been mixed, most show promise. As for how statins might work, one hypothesis is that OA might be a lipid disorder, says Umesh Kadam, PhD, senior lecturer in general practice epidemiology at Keele University. “There is also the possibility that statins have anti-inflammatory properties,” he says, “but this has yet to be proven.
Kadam, whose work has shown a link between OA and cardiovascular disease, says more research is needed to evaluate statins before doctors can recommend them as disease-modifying agents. For now, people who are already taking statins to lower cholesterol may find slowing of OA progression to be an added benefit.