An investigation of adherence to statin therapy in patients with rheumatoid arthritis

  • George Binkley

Student thesis: Master of Philosophy


BackgroundRheumatoid arthritis (RA) patients are more likely to experience a cardiovascularevent (CVE) than the general population. This is a result of atherosclerotic diseaseaugmented by systemic inflammation. HMG-CoA (3-hydroxy-3-methylglutarylcoenzyme A) reductase inhibitors (statins) lower the risk of CVEs;further, pleiotropic effects are of clinical relevance for RA disease activity. Manypatients do not achieve ideal clinical outcomes because of poor medicationadherence. This study sought to determine the rates and predictors of adherence inthe TRACE-RA population.MethodsData collected from the Trial of Atorvastatin for the primary prevention ofCardiovascular Events in patients with Rheumatoid Arthritis (TRACE-RA) wereused to meet these aims. Two thousand nine hundred and eighty six patients from102 centres were randomised to receive either atorvastatin or placebo. Adherencewas determined up to 3, 6 and 12 months using data on pill counts and self-reports.Rates and responses were dichotomised as adherent (>80% consumption or 'Mosttablets consumed') and non-adherent (
Date of Award1 Aug 2017
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorDeborah Symmons (Supervisor), George Kitas (Supervisor), Suzanne Verstappen (Supervisor) & Jamie Sergeant (Supervisor)


  • primary prevention
  • adherence
  • statin
  • rheumatoid arthritis
  • cardiovascular event

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