Clin Rheumatol. 2026 Apr 15. doi: 10.1007/s10067-026-08127-6. Online ahead of print.
ABSTRACT
INTRODUCTION: Statins are widely prescribed for lipid management and cardiovascular prevention, but their effects on gout risk remain unclear. Pitavastatin has distinct metabolic and anti-inflammatory properties, including upregulation of adiponectin and preservation of glucose transporter-4 expression, which may improve insulin sensitivity and modulate inflammatory pathways. This study aimed to evaluate whether pitavastatin use is associated with a reduced risk of gout compared with other statins.
METHODS: We conducted a retrospective cohort study using data from the Taiwan Longitudinal Generation Tracking Database 2005 of the National Health Insurance program. Patients aged ≥ 18 years who initiated pitavastatin or other statins between 2014 and 2021 were included. Those with prior gout or statin use before 2014 were excluded. After 1:4 propensity score matching for age, sex, comorbidities, and concomitant medications, 12,581 pitavastatin users and 50,324 users of other statins were analyzed. Gout incidence was compared using Kaplan-Meier analysis and Cox proportional hazards models.
RESULTS: During a mean follow-up of 3.1 years, 380 gout cases occurred among pitavastatin users (9.83 per 1000 person-years) and 2370 among other statin users (15.22 per 1000 person-years). Pitavastatin use was associated with a significantly lower risk of gout (adjusted hazard ratio, 0.64; 95% confidence interval, 0.58-0.72). The association with a lower risk remained consistent after stratification by sex and age and was most pronounced in patients with diabetes mellitus (aHR 0.53) and chronic liver disease (aHR 0.50).
CONCLUSIONS: Pitavastatin use was associated with a lower risk of incident gout compared with other statins in this nationwide cohort. Further prospective and mechanistic studies are needed to confirm these findings.
PMID:41986600 | DOI:10.1007/s10067-026-08127-6