Reader Comments
Post a new comment on this article
Post Your Discussion Comment
Please follow our guidelines for comments and review our competing interests policy. Comments that do not conform to our guidelines will be promptly removed and the user account disabled. The following must be avoided:
- Remarks that could be interpreted as allegations of misconduct
- Unsupported assertions or statements
- Inflammatory or insulting language
Thank You!
Thank you for taking the time to flag this posting; we review flagged postings on a regular basis.
closeAuthor's reply - Risk of bias
Posted by chodick on 13 Dec 2013 at 15:47 GMT
We thank the author for his/her comment. Smoking is indeed a potential confounder in this study. As the author points out, a recently published study has shown that adherent statins users are approximately 10% less likely to be smokers (1). However, a sensitivity analysis assuming that smoking is associated with a relative risk of 2.6 for rheumatoid arthritis (RA) (2) and that the relevant age-specific prevalence of smoking in Israel is approximately 11% (3), indicate that our study results would change only mildly after adjusting for smoking. For example, the hazard ratio for RA calculated for patients with proportion of days covered with statins of 80% or more would change from 0.69 (95% confidence interval: 0.57-0.83) to 0.71 (95%CI: 0.59-0.86). The results of the recent study do not suggest that alcohol consumption is related with adherence with statins.
References
1. Warren JR, Falster MO, Fox D, Jorm L. Factors influencing adherence in long-term use of statins. Pharmacoepidemiol Drug Saf. 2013 Dec;22(12):1298-307.
2. Heliövaara M, Aho K, Aromaa A, Knekt P, Reunanen A. Smoking and risk of rheumatoid arthritis. The Journal of Rheumatology [1993, 20(11):1830-1835]
3. Israel Ministry of Health, Smoking Status in Israel 2012, http://www.health.gov.il/....