Statins’ Dual Effect May Extend Survival of Ankylosing Spondylitis Patients, Study Finds

Cholesterol-lowering medications called statins may lower mortality rates in patients with ankylosing spondylitis more efficiently than in the general population, new research suggests.

The study, “Survival benefit of statin use in ankylosing spondylitis: a general population-based cohort study,” was published in the journal Annals of the Rheumatic Diseases (ARD).

Patients with ankylosing spondylitis, a chronic inflammatory condition, have been reported to have an increased risk for cardiovascular diseases and mortality.

In fact, “a recent large population-based cohort study showed that patients with ankylosing spondylitis are at a 60% higher risk for premature mortality compared with the general population,” researchers wrote.

The potential therapeutic benefits of statins in ankylosing spondylitis patients, when compared to their use in those without the disease, had been largely unknown.

Statins, also known as hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, are a class of drugs that help lower cholesterol levels in the blood and are often prescribed to reduce the risk for cardiovascular disease. Additionally, recent studies suggested that statins have a dual effect — they reduce not only cholesterol but also inflammation.

Now, researchers examined the potential survival benefit of statins in ankylosing spondylitis patients compared to the general population. The team recruited patients with ankylosing spondylitis who were at least 20 years old, and who were required to have at least one year of enrollment within the general practice before initiating therapy with statins.

The results showed that in this group of patients, statin therapy was associated with a 37 percent reduction in all-cause mortality. The association was independent of several factors, including patients’ age and gender, body mass index, cardiovascular medication use, total cholesterol levels, and healthcare utilization.

The level of reduction found in these patients was more pronounced than that observed in several meta-analyses of statin use for primary prevention in those who don’t have the disease.

“As patients with ankylosing spondylitis are affected by systemic inflammation and are at a higher risk for cardiovascular disease, the dual anti-inflammatory and lipid-lowering effects of statins may be more pronounced than in the general population,” the team suggested.

“As current guidelines for the management of cardiovascular risk in ankylosing spondylitis lack strong evidence-based recommendations for cardiovascular screening, our promising findings call for further studies to generate the high-level evidence needed to define the role of statin use in ankylosing spondylitis care,” the team concluded.