Therapy with statins in patients with refractory rheumatic diseases: a preliminary study.
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.
Abud-Mendoza
C
C
Unidad Regional de Reumatología y Osteoporosis, Hospital Central, San Luis Potosí, Mexico.
de la Fuente
H
H
Cuevas-Orta
E
E
Baranda
L
L
Cruz-Rizo
J
J
González-Amaro
R
R
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
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