Current and Emerging Uses of Statins in Clinical Therapeutics: A Review

Abstract

Statins, a class of cholesterol-lowering medications that inhibit 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase, are commonly administered to treat atherosclerotic cardiovascular disease. Statin use may expand considerably given its potential for treating an array of cholesterol-independent diseases. However, the lack of conclusive evidence supporting these emerging therapeutic uses of statins brings to the fore a number of unanswered questions including uncertainties regarding patient-to-patient variability in response to statins, the most appropriate statin to be used for the desired effect, and the efficacy of statins in treating cholesterol-independent diseases. In this review, the adverse effects, costs, and drug–drug and drug–food interactions associated with statin use are presented. Furthermore, we discuss the pleiotropic effects associated with statins with regard to the onset and progression of autoimmune and inflammatory diseases, cancer, neurodegenerative disorders, strokes, bacterial infections, and human immunodeficiency virus. Understanding these issues will improve the prognosis of patients who are administered statins and potentially expand our ability to treat a wide variety of diseases.

Big Data Reveal Insights into Alopecia Areata Comorbidities

“…Lipids and metabolic intermediates in the cholesterol biosynthesis pathway have been directly or indirectly linked to both immune responses and hair disorders. For example, cholesterol biosynthesis provides energy and raw materials required for the proliferation of cells of the immune system in response to activation (Getz and Reardon, 2014), and metabolic intermediates in the cholesterol biosynthetic pathway directly influence signaling pathways relevant to immune responses and hair growth, including JAK-signal transducer and activator of transcription and peroxisome proliferator-activated receptor signaling (Davies et al, 2016). Studies in mouse models and patients demonstrate that perturbations in the cholesterol biosynthesis pathway underlie some hair disorders (Stenn and Karnik, 2010; Evers et al, 2010).…”

“…Studies in mouse models and patients demonstrate that perturbations in the cholesterol biosynthesis pathway underlie some hair disorders (Stenn and Karnik, 2010; Evers et al, 2010). Finally, pharmacologic evidence and clinical trials in other autoimmune diseases, including rheumatoid arthritis, demonstrate that LDL-lowering therapies can mitigate risk and attenuate symptoms of autoimmune disease (Davies et al, 2016; Greenwood et al, 2006). …”

“…Although it is not clear if the inconsistency could be due to differences in study design or limitations in power, it is intriguing to note that within the study that found a beneficial effect (Lattouf et al, 2015), the mean regrowth for women (71%) was greater than the mean regrowth for men (57%), supporting our identification of a gender effect in LDL levels among patients with AA (Figure 3). Although evidence for the efficacy of statins in AA is tenuous, research in other AD, along with a strong body of mechanistic data, warrants pursuit of future clinical trials in patients with AA, and the initiation of studies in the mouse model of AA (Davies et al, 2016; Greenwood et al, 2006). …”

Different Effects of Atorvastatin on Cardiometabolic Risk Factors in Young Women With and Without Hyperprolactinemia

“…For this reason statins are the drugs of choice in the treatment of dyslipidemia and cardiovascular disease . Moreover, statins were found to be beneficial for treating numerous other disorders, including diabetes mellitus, multiple sclerosis, inflammatory bowel diseases, rheumatoid arthritis, systemic lupus erythematosus, Parkinson and Alzheimer diseases, cancer, and chronic obstructive pulmonary disease . Clinical benefits cannot be explained exclusively by the lipid‐lowering properties of HMG‐CoA reductase inhibitors but also by extralipid, so‐called “pleiotropic” effects.…”

“…4 Moreover, statins were found to be beneficial for treating numerous other disorders, including diabetes mellitus, multiple sclerosis, inflammatory bowel diseases, rheumatoid arthritis, systemic lupus erythematosus, Parkinson and Alzheimer diseases, cancer, and chronic obstructive pulmonary disease. 5,6 Clinical benefits cannot be explained exclusively by the lipid-lowering properties of HMG-CoA reductase inhibitors but also by extralipid, so-called "pleiotropic" effects. Non-lipid-related mechanisms of statin action include anti-inflammatory and antioxidative actions, immunomodulatory effects, cytoprotection of vascular endothelium, regulation of smooth muscle cell proliferation and migration, and favorable effects on coagulation, fibrinolysis, and platelet activities.…”