Abstract 12513: Anti-Inflammatory Effect of Statin Among Patients With Rheumatoid Arthritis: A Network Meta-Analysis of Randomized Controlled Trials

Background: Rheumatoid arthritis (RA) have shown to be associated with a higher risk of acute coronary syndrome and atrial fibrillation. However, the impact of statin among RA patients is not well studied, with conflicting results. Objective: We aim to compare the anti-inflammatory effect of different statin drugs among patients with rheumatoid arthritis in this network meta-analysis (NMA). Methods: We performed a systematic literature search on the electronic database for relevant randomized controlled trials (RCTs) from inception until 25th May 2023. A network meta-analysis was conducted to evaluate the anti-inflammatory effect of different statin drugs among RA patients. We presented results as mean difference (MD) and 95% confidence interval. Results: A total of 16 RCTs with a total of 3,886 patients (1,938 in the statin group and 1,948 in the non-statin group) were included. The network meta-analysis showed that Atorvastatin was the only intervention that significantly decreased the mean difference of all the inflammatory predictors including ESR (MD= -6.77, 95% CI= [-9.52, -4.01], P<0.01), CRP (MD= -2.93, 95% CI= [-5.06, -0.79], P<0.01), DAS28 (MD= -0.62, 95% CI: [-0.85,-0.39], P<0.01); and IL-6 (MD= -9.28, 95% CI= [-16.04,-2.53], P<0.01) in RA patients when compared to placebo. However, Atorvastatin showed no statistically significant difference for TNF compared to Placebo (MD: -31,51 with 95% CI [-75.54,12.52], P = 0.16). Regarding the other interventions, they showed no significant effect on the mean difference of any of the inflammatory markers. Conclusion: The findings of our study indicate that atorvastatin is associated with a significant decrease in the inflammatory markers among rheumatoid arthritis patients compared with other statin therapy. Overall, these results have significant implications for patients with RA who would benefit from the stain anti-inflammatory effect.