Statin strikes out in knee osteoarthritis

In patients with symptomatic knee osteoarthritis (OA), treatment with atorvastatin falls short of reducing cartilage volume loss over 2 years as compared with placebo, according to the results of a trial.

The multicentre trial randomized 304 patients (mean age 55.7 years, 55.6 percent female) with knee OA to receive atorvastatin 40 mg orally (n=151) or matching placebo (n=153) once daily. Most of these patients (81.6 percent) completed the trial.

There was a minimal difference in the primary endpoint of annual percentage change in tibial cartilage volume (measured using magnetic resonance imaging [MRI]) over 2 years. Atorvastatin-treated patients recorded an annual decrease of 1.66 percent, while those on placebo saw a yearly decrease of 2.17 percent (difference, 0.50 percent, 95 percent confidence interval [CI], –0.17 to 1.17).

Likewise, the annual change in tibial cartilage volume was similar in the two treatment groups.

Results were the same for the prespecified secondary endpoints. There were no significant between-group differences seen in progression of cartilage defects (odds ratio [OR], 0.86, 95 percent CI, 0.52–1.41) or bone marrow lesions (OR, 1.00, 95 percent CI, 0.62–1.63), change in pain (–36.0 vs –29.5, adjusted difference, –2.7, 95 percent CI, –27.1 to 21.7), stiffness (–14.2 vs –11.8, adjusted difference, –0.2, 95 percent CI, –12.2 to 11.8), or function (–89.4 vs –87.5, adjusted difference, 0.3, 95 percent CI, –83.1 to 83.6).

Adverse events occurred with similar frequency in the atorvastatin (n=57, 37.7 percent) and placebo (n=52, 34.0 percent) groups.

The present data do not support use of atorvastatin in the treatment of knee OA.