There is an increased mortality of ankylosing spondylitis (AS) patients compared to the general population. Factors that contributed to this increased mortality are a lower level of education, and the development of diabetes, infections, and pulmonary and cardiovascular diseases. Overall, doctors estimate there is a 53% increased risk of mortality for men, and a 83% increase for women.1
Despite this sobering news, not all is lost. Another study just released identified potential benefits in taking statin drugs on improving the survival of AS patients with cardiovascular co-morbidities.2 In the study doctors compared AS patients with a minimum of 1 year diagnosis between 2000 and 2014 to individual without AS in the general population. Overall 1430 patients with AS who started a statin drug to lower cholesterol were compared to a similar number who did not. Obviously individuals started on a statin drug had more cardiovascular disease and were more likely to be taking other heart medicines.
When doctors evaluated the mortality rates of the two groups they found that individuals taking the statin drug had a lower mortality rate despite being at greater risk. Overall the mortality rate was 16.5 per 1000 patient years versus 23.8 for the non-statin patients. The absolute mortality rate difference was 7.3 deaths per 1000 patient years for the non-statin patients. Statin use was associated with a 37% reduction in all-cause mortality. The size of this reduction is greater than that associated with rheumatoid arthritis.
Further studies will be needed to determine if statins have a beneficial effect on mortality in AS patients independent of their cardiovascular status.
David Borenstein, MD
Executive Editor The Spine Community.com
- Exafchou S, Lie E, Lindstrom U et al. Mortality in ankylosing spondylitis: results from a nationwide population-based study. Ann Rheum Dis 2016;75:1466-72.
- Oza A, Schoenfeld SR, Fisher MC, et al. Survival benefit of statin use in ankylosing spondylitis: a general population-based cohort study.htttp://dx.doi.org/10.1136/annrheumdis-2017-211253