Outcome of rheumatoid arthritis following adjunct statin therapy

Abstract

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.

Fluvastatin prevents the development of arthritis in env-pX rats via up-regulation of Rho GTPase-activating protein 12

“…In the trial of atorvastatin in RA (a 6-month period, placebo-controlled, and randomized clinical trial with atorvastatin), the additional treatment with atorvastatin was suggested to reduce RA activity (p=0.004), swollen joint scores (p=0.006), and serum C-reactive protein levels (p<0.001; McCarey et al, 2004). Moreover, other reports also supported the opposite correlation between statin use and RA risk (Chodick et al, 2010;Das et al, 2015). However, there is a report demonstrating that statin has no apparent effect on RA activity (Akiyama et al, 2015).…”

“…Thus, expectedly, statins can also mediate cholesterol-unrelated effects, such as anti-inflammatory, antiproliferative, antioxidant, immunomodulatory, and antithrombotic effects (DuBroff and de Lorgeril, 2015) without immunosuppression. In addition, some cohort studies have suggested the benefits of statin use in RA patients (Chodick et al, 2010;Das et al, 2015;McCarey et al, 2004). However, it remains to be revealed how statins affect the pathogenesis of RA.…”

Evaluation of the Risk of Getting Peripheral Artery Disease in Rheumatoid Arthritis and the Selection of Appropriate Diagnostic Methods

“…Statin supplement is expected to be beneficial in RA. It reduces the production of inflammatory molecules and disrupts the oxidative stress/inflammation cycle [35]. Tetrahydrobiopterin (BH4) is a cofactor of nitric oxide synthase.…”

Extra-Articular Manifestations of Rheumatoid Arthritis

“…При симптоматических заболеваниях перикарда глюкокортикоиды (ГК) и нестероидные проти-вовоспалительные препараты (НПВП) вызывают быстрое улучшение [35]. Имеются указания, что статины, благода-ря своему плейоторопному действию на воспалительные и иммунные медиаторы, могут не только улучшать тече-ние РА, но и уменьшать кардиологические и сосудистые ВП [36]. Эпидемиологические исследования обнаружили, что сердечно-сосудистая смертность высока у больных ранним и развернутым РА и неожиданно выше у женщин, традиционно имеющих низкий риск сердечно-сосудистой смертности [33,37].…”