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Statin Use and Mri Subchondral Bone Marrow Lesion Worsening in Generalized Osteoarthritis: Longitudinal Analysis From Osteoarthritis Initiative Data Publisher Pubmed



Mohajer B1 ; Guermazi A2 ; Conaghan PG3 ; Berenbaum F4 ; Roemer FW2, 5 ; Hajmirzaian A1 ; Bingham CO6 ; Moradi K7 ; Cao X8 ; Wan M8 ; Demehri S1
Authors
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Authors Affiliations
  1. 1. Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
  2. 2. Department of Radiology, Boston University School of Medicine, Boston, MA, United States
  3. 3. Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds, United Kingdom
  4. 4. Department of Rheumatology, Sorbonne University, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France
  5. 5. Department of Radiology, Universitatsklinikum Erlangen & Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Germany
  6. 6. Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, MD, United States
  7. 7. Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States

Source: European Radiology Published:2022


Abstract

Objectives: To determine the association between statin therapy and knee MRI-detected subchondral bone marrow lesion (BML) longitudinal worsening in patients with Heberden’s nodes (HNs) as the hallmark of generalized osteoarthritis (OA) phenotype. Methods: All participants gave informed consent, and IRB approved HIPAA-compliant protocol. We assessed the worsening in BML volume and number of affected subregions in the Osteoarthritis Initiative (OAI) participants with HNs at baseline clinical examination (HN+), using the semi-quantitative MRI Osteoarthritis Knee Scores at baseline and 24 months. Participants were classified according to baseline BML involvement as “no/minimal” (≤ 2/14 knee subregions affected and maximum BML score ≤ 1) or “moderate/severe.” Statin users and non-users were selected using 1:1 propensity-score (PS) matching for OA and cardiovascular disease (CVD)–related potential confounding variables. We assessed the association between statin use and increasing BML score and affected subregions using adjusted mixed-effect regression models. Results: The PS-matched HN+ participants (63% female, aged 63.5 ± 8.5-year-old) with no/minimal and moderate/severe BML cohorts consisted of 332 (166:166, statin users: non-users) and 380 (190:190) knees, respectively. In the HN+ participants with no/minimal BML, statin use was associated with lower odds of both BML score worsening (odds ratio, 95% confidence interval: 0.62, 0.39–0.98) and increased number of affected subregions (0.54, 0.33–0.88). There was no such association in HN– participants or those HN+ participants with baseline moderate/severe BML. Conclusion: In patients with CVD indications for statin therapy and generalized OA phenotype (HN+), statin use may be protective against the OA-related subchondral bone damage only in the subgroup of participants with no/minimal baseline BML. Key Points: • Statin use may reduce the risk of subchondral bone damage in specific osteoarthritis patients with a generalized phenotype, minimal subchondral bone damage, and cardiovascular statin indications. © 2022, The Author(s), under exclusive licence to European Society of Radiology.
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