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Ann Rheum Dis. 2017 Oct;76(10):1723-1730. doi: 10.1136/annrheumdis-2016-210936. Epub 2017 Jul 6.

Pattern of risks of systemic lupus erythematosus among statin users: a population-based cohort study.

Author information

Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
Division of Pharmacoepidemiology and Clinical Pharmacology, Department of Pharmaceutical Sciences, Faculty of Sciences, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
Health eResearch Centre, Farr Institute for Health Informatics Research, University of Manchester, Manchester, UK.
Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Clinical Pharmacy & Toxicology, Maastricht University Medical Center, Maastricht, The Netherlands.
Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
Department of Toxicogenomics, Maastricht University Medical Center, Maastricht, The Netherlands.
Department of Clinical and Experimental Immunology, Maastricht University, Maastricht, The Netherlands.



To examine the association between the use of statins and the risk of systemic lupus erythematosus (SLE) with focus on describing the patterns of risks over time.


A population-based cohort study using the UK Clinical Practice Research Datalink.


All patients aged 40 years or older who had at least one prescription of statins during the period 1995-2009 were selected and matched by age, sex, practice and date of first prescription to non-users. The follow-up period of statin users was divided into periods of current, recent and past exposure, with patients moving among these three exposure categories over time. Current statin users were also stratified into ≤1 year or >1 year of use.


Time-dependent Cox models were used to calculate HRs of SLE, adjusted for disease history and previous drug exposure.


We included 1 039 694 patients, of whom 519 847 were statin users. Current statin users did not have an increased risk of developing SLE among patients aged ≥40 years (HRadjusted 0.75, 95% CI 0.53 to 1.07). Current statin users who continued the therapy for >1 year had a 38% lower risk of developing SLE (HRadjusted 0.62, 95% CI 0.42 to 0.93). When more specific definitions for SLE were used, this latter finding, however, was not observed.


Our findings showed no effect of statins on the risk of developing SLE among patients aged ≥40 years. Further research is needed to study the long-term effects of statins on SLE.


epidemiology; immunomodulation; population-based; statins; systemic lupus erythematosus

[Indexed for MEDLINE]

Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at and declare financial support from the National Institute for Public Health and the Environment (RIVM; research grant S340040) for the submitted work. Dr Klungel has received funding for pharmacoepidemiological research from the Dutch private@public Top Institute Pharma (Grant T6.101 Mondriaan) and the Innovative Medicines Initiative Joint Undertaking under Grant Agreement No 115004, resources of which comprise financial contribution from the European Union’s Seventh Framework Program (FP7/2007-2013) and EFPIA companies' in kind contribution. OHK had full access to all of the data in this study and takes responsibility for the integrity of the data and accuracy of the data analysis. All authors had final responsibility for the decision to submit the manuscript for publication.

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