Therapy with statins in patients with refractory rheumatic diseases: a preliminary study

Lupus. 2003;12(8):607-11. doi: 10.1191/0961203303lu429oa.

Abstract

We have explored the therapeutic potential of statins in patients with different inflammatory rheumatic diseases refractory to conventional therapy. We found that simvastatin (80mg o.d. for eight days) induced a rapid and significant reduction in proteinuria levels in three systemic lupus erythematosus (SLE) patients. A similar kind of therapy had a marked beneficial effect in a patient with Wegener's granulomatosis and a patient with erythema nodosum. On the other hand, five patients with rheumatoid arthritis (RA) who received atorvastatin for eight days (20mg/day) showed reduction in C-reactive protein levels and a clinical improvement that was classified as an ACR20 response. Prior to the administration of statins, all these patients had received aggressive conventional therapy with no satisfactory response. A significant reduction in spontaneous apoptosis of peripheral blood lymphocytes and expression of CD69 and HLA-DR was observed in SLE patients after simvastatin therapy. These results prompted us to perform a pilot short-time comparative (simvastatin versus chloroquine) open clinical trial in 15 patients with RA who were receiving methotrexate as a single disease modifying antirheumatic drug with no satisfactory response. Most patients (9/10) who received simvastatin (40mg/day) showed an ACR50 or better response after eight weeks, whereas such a response was not observed in any patient (0/5) treated with chloroquine. Our preliminary results indicate that statins may be an important therapeutic tool for the treatment of inflammatory rheumatic diseases.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antirheumatic Agents / therapeutic use
  • Atorvastatin
  • Biomarkers / blood
  • Blood Sedimentation / drug effects
  • C-Reactive Protein / drug effects
  • C-Reactive Protein / metabolism
  • Child
  • Chloroquine / therapeutic use
  • Dose-Response Relationship, Drug
  • Granulomatosis with Polyangiitis / drug therapy
  • Granulomatosis with Polyangiitis / metabolism
  • HLA-DR Antigens / drug effects
  • HLA-DR Antigens / metabolism
  • Heptanoic Acids / therapeutic use
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Leukocytes, Mononuclear / drug effects
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / metabolism
  • Middle Aged
  • Proteinuria / chemically induced
  • Proteinuria / metabolism
  • Pyrroles / therapeutic use
  • Rheumatic Diseases / drug therapy*
  • Rheumatic Diseases / metabolism
  • Rheumatic Fever / drug therapy
  • Rheumatic Fever / metabolism
  • Simvastatin / therapeutic use
  • Treatment Outcome

Substances

  • Antirheumatic Agents
  • Biomarkers
  • HLA-DR Antigens
  • Heptanoic Acids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Pyrroles
  • Chloroquine
  • C-Reactive Protein
  • Atorvastatin
  • Simvastatin