ACR

ACR 2024: Statins reduce CV risk in RA patients on tofacitinib

November 20, 2024

Major adverse cardiovascular events (MACE) were not more common in those assigned to tofacitinib and also using statins than among those participants randomized to tumor necrosis factor inhibitors (TNFi) in the landmark ORAL Surveillance study. The findings highlight the gap in the CV preventive care of patients with RA, as evidenced by the inadequate use of statins. Among those with a history of ASCVD, use of statins is critical in mitigating the MACE risk associated with the use of tofacitinib. Results were shared at the American College of Rheumatology annual meeting.

Patients with RA aged ≥50 years and with ≥1 additional CV risk factor received either tofacitinib 5 mg (n = 1,455) or 10 mg (n = 1,456), or TNFi (n = 1,451). Statin use was assessed at baseline and during the study and classified as high-, moderate-, or low-intensity treatment.

Key findings

Among patients with a history of atherosclerotic CV disease (ASCVD) or high CV risk, 53% and 27%, respectively, used a statin at baseline. During the study, statin initiation was more frequent with tofacitinib (11.8% for 5 mg; 12.2% for 10 mg) than with TNFi (6.7%). In the overall study population and across treatments, MACE rates were similar with or without baseline statin use. Among tofacitinib-treated patients with ASCVD, those using statins had a lower incidence of MACE (HR 0.49) compared with those not using statins. The occurrence of MACE was higher with tofacitinib vs. TNFi among those with an ASCVD history and no use of statins at any time (HR 4.07 [95% CI 1.20, 13.82]). No difference was observed in incident MACE with tofacitinib vs. TNFi in patients with ASCVD history and use of statins at baseline or at any time (HR 1.17 [95% CI 0.48, 3.00]).

Source:

Giles, J., et al. (2024, November 17). Use of Statins and Its Association with Major Adverse Cardiovascular Outcomes with Tofacitinib versus TNF Inhibitors in a Risk-Enriched Population of Patients with Rheumatoid Arthritis. Abstract #1745. Presented at ACR Convergence 2024. https://acrabstracts.org/abstract/use-of-statins-and-its-association-with-major-adverse-cardiovascular-outcomes-with-tofacitinib-versus-tnf-inhibitors-in-a-risk-enriched-population-of-patients-with-rheumatoid-arthritis/