Potential antiinflammatory and immunomodulatory effects of statins in rheumatologic therapy

Arnaud, Claire; Mach, François

doi:10.1002/art.21757

Cited by 22 publications

(15 citation statements)

References 72 publications

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“…In addition, statins also have a wide variety of properties that are independent of their lipid-lowering ability, termed “pleiotropic effects” [6-8]. Many observational studies have demonstrated a significant protective effect from statins in patients with sepsis, and previous meta-analysis showed a similar outcome [9,10].…”

Section: Introductionmentioning

confidence: 99%

Effect of statin therapy on mortality from infection and sepsis: a meta-analysis of randomized and observational studies

et al. 2014

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IntroductionObservational data have suggested that statin therapy may reduce mortality in patients with infection and sepsis; however, results from randomized studies are contradictory and do not support the use of statins in this context. Here, we performed a meta-analysis to investigate the effects of statin therapy on mortality from infection and sepsis.MethodsWe searched electronic databases (PubMed and Embase) for articles published before November 2013. Randomized or observational studies reporting the effects of statin therapy on mortality in patients with infection or sepsis were eligible. Randomized and observational studies were separately pooled with relative risks (RRs) and random-effects models.ResultsWe examined 5 randomized controlled trials with 867 patients and 27 observational studies with 337,648 patients. Among the randomized controlled trials, statins did not significantly decrease in-hospital mortality (RR, 0.98; 95% confidence interval (CI), 0.73 to 1.33) or 28-day mortality (RR, 0.93; 95% CI, 0.46 to 1.89). However, observational studies indicated that statins were associated with a significant decrease in mortality with adjusted data (RR, 0.65; 95% CI, 0.57 to 0.75) or unadjusted data (RR, 0.74; 95% CI, 0.59 to 0.94).ConclusionsLimited evidence suggests that statins may not be associated with a significant reduction in mortality from infection and sepsis. Although meta-analysis from observational studies showed that the use of statins was associated with a survival advantage, these outcomes were limited by high heterogeneity and possible bias in the data. Therefore, we should be cautious about the use of statins in infection and sepsis.

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Section: Introductionmentioning

confidence: 99%

Effect of statin therapy on mortality from infection and sepsis: a meta-analysis of randomized and observational studies

et al. 2014

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“…TNF is known to be a key cytokine driving chronic inflammation in RA, as has been demonstrated by the clinical success of anti-TNF biological therapies (47). This reduction in TNF may in part be due to inhibition of TLR8; however, in RA patients, long-term simvastatin use may have multiple effects that together generate the clinical benefits observed, such as the reduction of expression and function of other TLRs, decreased cell proliferation and a reduction in inflammation initiated by other pathways (8)(9)(10)(11)44).…”

Section: Simvastatin Inhibits Spontaneous Tnf Production From Human Rmentioning

confidence: 99%

“…This antiinflammatory effect of statins has been reported to decrease clinical symptoms of disease in patients with RA (8)(9)(10)(11) and have also been observed to have prophylactic and therapeutic efficacy in the collagen-induced arthritis mouse model (12). However, the precise mechanisms by which statins exert these effects have not yet been fully elucidated.…”

mentioning

confidence: 99%

Simvastatin Inhibits Toll-like Receptor 8 (TLR8) Signaling in Primary Human Monocytes and Spontaneous Tumor Necrosis Factor Production from Rheumatoid Synovial Membrane Cultures

Mullen

Ferdjani

Sacre

2015

Mol Med

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“…Statins have also been proven to have antiinflammatory and immunomodulation effects, including the reduction of inflammatory cytokines, chemotaxis, and neutrophil migration. [10,11] Due to of the proposed pleiotropic immunomodulatory effects of statins, a large number of observational studies and randomized control trials were conducted, from the years 2004 to 2013. [12] However, the effects of statins remain a major controversy; most RCTs showed no benefits regarding statins in mortality during sepsis, while observational studies have shown a protective effect.…”

Section: Introductionmentioning

confidence: 99%

Statins improve the long-term prognosis in patients who have survived sepsis

Hsieh²,

Lin

et al. 2019

Medicine

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Potential antiinflammatory and immunomodulatory effects of statins in rheumatologic therapy

Cited by 22 publications

References 72 publications

Effect of statin therapy on mortality from infection and sepsis: a meta-analysis of randomized and observational studies

Effect of statin therapy on mortality from infection and sepsis: a meta-analysis of randomized and observational studies

Simvastatin Inhibits Toll-like Receptor 8 (TLR8) Signaling in Primary Human Monocytes and Spontaneous Tumor Necrosis Factor Production from Rheumatoid Synovial Membrane Cultures

Statins improve the long-term prognosis in patients who have survived sepsis

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