title: Therapy with statins in patients with refractory rheumatic diseases: a preliminary study.
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.
authors.affiliation: Unidad Regional de Reumatología y Osteoporosis, Hospital Central, San Luis Potosí, Mexico.
authors.forename: C
authors.initials: C
authors.lastname: Abud-Mendoza
authors.forename: H
authors.initials: H
authors.lastname: de la Fuente
authors.forename: E
authors.initials: E
authors.lastname: Cuevas-Orta
authors.forename: L
authors.initials: L
authors.lastname: Baranda
authors.forename: J
authors.initials: J
authors.lastname: Cruz-Rizo
authors.forename: R
authors.initials: R
authors.lastname: González-Amaro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D000069059:Atorvastatin; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation / Q000187:drug effects; D002097:C-Reactive Protein / Q000187:drug effects / Q000378:metabolism; D002648:Child; D002738:Chloroquine / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D014890:Granulomatosis with Polyangiitis / Q000188:drug therapy / Q000378:metabolism; D006684:HLA-DR Antigens / Q000187:drug effects / Q000378:metabolism; D006538:Heptanoic Acids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007963:Leukocytes, Mononuclear / Q000187:drug effects; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy / Q000378:metabolism; D008875:Middle Aged; D011507:Proteinuria / Q000139:chemically induced / Q000378:metabolism; D011758:Pyrroles / Q000627:therapeutic use; D012216:Rheumatic Diseases / Q000188:drug therapy* / Q000378:metabolism; D012213:Rheumatic Fever / Q000188:drug therapy / Q000378:metabolism; D019821:Simvastatin / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D015415:Biomarkers; D006684:HLA-DR Antigens; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D002738:Chloroquine; D002097:C-Reactive Protein; D000069059:Atorvastatin; D019821:Simvastatin