Trial reportRMD open2021
Atorvastatin is unlikely to prevent rheumatoid arthritis in high risk individuals: results from the prematurely stopped STAtins to Prevent Rheumatoid Arthritis (STAPRA) trial.
Trial report in RMD open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Autoantibodies as predictors of progression to rheumatoid arthritis: a systematic review and meta-analysis.RMD open · 2026Pooled it
- Does the use of statins alter the risk of rheumatoid arthritis? A systematic review and meta-analysis.PloS one · 2024Pooled it
- A Phase 2 Trial of Hydroxychloroquine in Individuals at Risk for Rheumatoid Arthritis.Arthritis & rheumatology (Hoboken, N.J.) · 2026Trial
- Serum Proteomic Signatures of Rheumatoid Arthritis Risk and Response: Analysis of a Rheumatoid Arthritis Interception Trial.Arthritis & rheumatology (Hoboken, N.J.) · 2026Article
- Natural products as HMG-CoA reductase inhibitors (statins) for the management of non-communicable diseases.Inflammopharmacology · 2026Review
- Exploring cardiovascular risk management implementation in Dutch rheumatoid arthritis patients: insights from rheumatologists and patients.Rheumatology advances in practice · 2026Article
- Living with palindromic rheumatism: a qualitative interview study.Rheumatology advances in practice · 2026Article
- Treating connective tissue disease-associated interstitial lung disease - think outside the box: a perspective.European respiratory review : an official journal of the European Respiratory Society · 2025Review
- Deep immunophenotyping reveals circulating activated lymphocytes in individuals at risk for rheumatoid arthritis.The Journal of clinical investigation · 2025Article
- Precision Medicine in Rheumatology: The Role of Biomarkers in Diagnosis and Treatment Optimization.Journal of clinical medicine · 2025Review
- Are seronegative patients with rheumatoid arthritis and clinically suspect arthralgia properly represented in randomized clinical trials?Clinical rheumatology · 2025Review
- The So-Called Pre-Clinical Rheumatoid Arthritis: Doubts, Challenges, and Opportunities.Journal of clinical medicine · 2024Article
- Multi-Autoantibody Testing Identifies Expansion of Reactivity to Targeted Antigens Before a Diagnosis of Rheumatoid Arthritis.ACR open rheumatology · 2024Article
- Expansion of HLA-DR Positive Peripheral Helper T and Naive B Cells in Anticitrullinated Protein Antibody-Positive Individuals At Risk for Rheumatoid Arthritis.Arthritis & rheumatology (Hoboken, N.J.) · 2024Article
- Rheumatoid Arthritis: The Continuum of Disease and Strategies for Prediction, Early Intervention, and Prevention.The Journal of rheumatology · 2024Review
- Rheumatoid Arthritis: The Continuum of Disease and Strategies for Prediction, Early Intervention, and Prevention.The Journal of rheumatology · 2024Review
- 'What is my risk really?': a qualitative exploration of preventive interventions among individuals at risk of rheumatoid arthritis.Rheumatology advances in practice · 2024Article
- Multifaceted immune dysregulation characterizes individuals at-risk for rheumatoid arthritis.Nature communications · 2023Article
- Preferences for preventive treatments for rheumatoid arthritis: discrete choice survey in the UK, Germany and Romania.Rheumatology (Oxford, England) · 2023Article
- Article
Corrections and comments
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Authors and funding
12 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesPersons at high risk of rheumatoid arthritis (RA) might benefit from a low-risk pharmacological intervention aimed at primary prevention. Previous studies demonstrated disease-modifying effects of statins in patients with RA as well as an association between statin use and a decreased risk of RA development. A randomised, double-blind, placebo-controlled trial investigated whether atorvastatin could prevent arthritis development in high-risk individuals.
methodsArthralgia patients with anticitrullinated protein antibody (ACPA) >3 xULN or ACPA and rheumatoid factor, without (a history of) arthritis, were randomised to receive atorvastatin 40 mg daily or placebo for 3 years. The calculated sample size was 220 participants. The primary endpoint was clinical arthritis. Cox regression analysis was used to determine the effect of atorvastatin on arthritis development.
resultsDue to a low inclusion rate, mainly because of an unwillingness to participate, the trial was prematurely stopped. Data of the 62 randomised individuals were analysed. Median follow-up was 14 (inner quartiles 6-35) months. Fifteen individuals (24%) developed arthritis: 9/31 (29%) in the atorvastatin group; 6/31 (19%) in the placebo group: HR 1.40, 95% CI 0.50 to 3.95.
conclusionsIn this small set of randomised high-risk individuals, we did not demonstrate a protective effect of atorvastatin on arthritis development. The main reason for the low inclusion was unwillingness to participate; this may also impede other RA prevention trials. Further research to investigate and solve barriers for prevention trial participation is needed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.