[fr] Objectifs. – Les études épidémiologiques et fondamentales suggèrent que les désordres lipidiques puissent être impliqués dans la physiopathologie de la gonarthrose. Les diverses études ayant évalué l’effet des statines ont montré des résultats contradictoires. Nous avons étudié l’effet des statines sur la progression radiologique chez des patients atteints d’une gonarthrose symptomatique confirmée sur les radiographies. Méthodes. – 336 patients issus du groupe placebo de l’essai SEKOIA ont complété les 3 ans de suivi et ont été inclus dans cette analyse post-hoc. La prise de statines était évaluée lors de la visite d’inclusion. La mesure de l’interligne articulaire fémoro-tibiale minimale était effectuée sur des radiographies standards selon une méthode automatisée à l’inclusion puis de façon annuelle. La progression radiologique était définie comme un pincement ≥ 0,5 mm sur 3 ans. Résultats. – 71 patients étaient sous statines (21,1 %). Comparativement aux sujets non traités, ils avaient un BMI supérieur (31,1 ± 5,3 vs. 29,3 ± 5,2 kg/m2, p = 0,008) et un plus grand nombre de facteurs métaboliques (≥ 3 facteurs : 43,7 % vs. 7,2 % ; pet < 0,001). La progression radiologique était plus fréquente chez les patients sous statines (49,3 % vs. 32,1 %, pet = 0,007). L’association entre la progression radiologique et l’utilisation de statines était indépendante de l’âge, du sexe, du WOMAC global, de la durée d’évolution, de la sévérité du pincement articulaire, de l’hypertension, du diabète de type 2, de l’obésité (BMI > 30 kg/m2)et des maladies cardiovasculaires [risque relatif 1,49 (IC95 % 1,10–2,02), pet = 0,010]. Conclusion. – Chez les patients ayant une gonarthrose symptomatique, l’utilisation de statines était associée à une plus grande progression radiologique indépendamment des facteurs confondants (obésité, diabète de type 2, hypertension, durée de la maladie, intensité des symptômes et sévérité radiologique).
Disciplines :
General & internal medicine
Author, co-author :
Eymard, F.; Département de rhumatologie, CHU Henri Mondor, AP–HP, Créteil cedex, 94010, France
Parsons, C.; MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, SO16 6YD, United States
Edwards, M. H.; MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, SO16 6YD, United States
Petit-Dop, F.; Innovative Pole of Rheumatology, Servier, Suresnes, 92150, France
Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Bruyère, Olivier ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Chevalier, X.; Département de rhumatologie, CHU Henri Mondor, AP–HP, Créteil cedex, 94010, France
Cooper, C.; MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, SO16 6YD, United States
Richette, P.; Département de rhumatologie, CHU Lariboisière, AP–HP, Paris cedex 10, 75475, France, Inserm U1132, Université Paris 7, CHU Lariboisière, AP–HP, Paris cedex 10, 75475, France
Language :
French
Title :
Impact du traitement par statines dans la progression radiologique de la gonarthrose: résultats issus de l'analyse post-hoc de l'essai SEKOIA
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