Simvastatin in primary biliary cirrhosis: effects on serum lipids and distinct disease markers.
OBJECTIVE
Primary biliary cirrhosis (PBC) is an autoimmune disease of the liver with inflammation of small and middle-sized bile ducts. Serum lipids are frequently elevated, but the use of a lipid lowering drug therapy in PBC is still a matter of debate. Application of an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase in hypercholesterolemic PBC patients was therefore the subject of the present study.


METHODS
Six female patients (aged 46.5 (32-61) years; median (range)) were treated with the HMG-CoA reductase inhibitor simvastatin (5 or 20 mg/day). Levels of serum total cholesterol, low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol were determined prior to and after 2 months of treatment. Concentrations of serum markers of cholestasis, antimitochondrial antibodies (AMA), and immunoglobulins A, G and M were also assessed.


RESULTS
Simvastatin significantly (P<0.05) reduced serum levels of total cholesterol, LDL cholesterol, alkaline phosphatase, -glutamyltransferase, and immunoglobulin M (by 19, 26, 12, 37 and 14%, respectively).


CONCLUSIONS
The lipid lowering potency of the HMG-CoA reductase inhibitor simvastatin was confirmed in hypercholesterolemic patients with PBC. The drug might also prove useful as modulator of cholestasis and of immune response in this disease.
Ritzel
Uwe
U
Division of Gastroenterology and Endocrinology, Department of Medicine, University of Göttingen, Robert-Koch-Strasse 40, D-37075 Göttingen, Germany.
Leonhardt
Urs
U
Näther
Martina
M
Schäfer
Gertrud
G
Armstrong
Victor W
VW
Ramadori
Giuliano
G
D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D007075:Immunoglobulin M / Q000097:blood; D008055:Lipids / Q000097:blood*; D008105:Liver Cirrhosis, Biliary / Q000097:blood* / Q000188:drug therapy*; D008875:Middle Aged; D019821:Simvastatin / Q000627:therapeutic use*; D005723:gamma-Glutamyltransferase / Q000097:blood
D015415:Biomarkers; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D007075:Immunoglobulin M; D008055:Lipids; D002784:Cholesterol; D019821:Simvastatin; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase