Objective:Rheumatoid arthritis (RA) is characterized by symmetric peripheral polyarthritis, inflammatory synovitis, and articular destruction. Statins, 3-hydroxy-3-methylglutaryl coenzyme A-reductase inhibitors, mediate significant vascular risk reduction in patients with coronary artery disease by promoting reduction in plasma levels of low-density-lipoprotein cholesterol. Extensive in vitro data, experimental studies and more recently few clinical trials have strongly suggested statins to possess an important role in RA mainly mediated by their anti-inflammatory and immunomodulatory properties. The objective of this study was to evaluate the effect of adjunct statin therapy in comparison to standard disease modifying antirheumatic drugs (DMARD) therapy in patients with RA.Materials and Methods:In this observational study, diagnosed RA patients of age group between 40 and 60 years were selected as per the inclusion criteria from the rheumatology outdoor. From the selected patients, we identified two separate groups of patients. Group 1 included 30 patients of RA currently under DMARD therapy with adjunct statin medication. Group 2 included 30 patients of RA currently under DMARD therapy. Patients were followed up over 6 months. Standard parameters such as disease activity score (DAS28), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were recorded for comparing the outcome of RA in both groups.Results:Out of a total of 60 patients who took part in the study, significant beneficial role of adjunct statin medication was found in this study when prescribed along with conventional DMARDs in active RA patients. The mean DAS28, considered by far as the most important index of clinical disease activity in RA, was found to be significantly lower (P < 0.05) in the adjunct statin-treated group (group 1) than that of the conventional DMARD treated group (group 2) after 6 months of continuous therapy. Other two important biochemical markers of RA disease activity, that is, ESR and CRP were also found to be significantly lower (P < 0.05) in RA patients who were on adjunct statin medication (group 1) than in group 2 comprising RA patients only under conventional DMARDs therapy without statin medication.Conclusion:The results suggest an adjunct and potentially beneficial role of statin therapy in active cases of RA, producing significant clinical and biochemical improvement.
Background: Connective tissue disorders (CTD) are mostly due to inflammatory and fibrotic tissue injury. Glucocorticoids and immunomodulators though useful but are toxic. Mycophenolate mofetil (MMF) is now being used successfully in many autoimmune diseases, but the safety of MMF in CTD patients is yet to be conclusively established.Methods: The study was a retrospective record based observational one in patients of CTD satisfying the predetermined inclusion criteria. Various safety parameters were noted down from the observed records and analysed accordingly.Results: The 120 case records of CTD patients were analysed for a specific set of safety parameters over the preceding one year. Diarrhoeal attacks were the most commonly encountered side effect (38.3%) of long term patients who were on mycophenolate therapy followed by infection.Conclusions: Mycophenolate was found to be generally well tolerated in CTD patients with few reports of adverse events, but larger clinical trials are needed to conclusively establish its safety.
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