title: A pravastatin dose-escalation study in systemic lupus erythematosus.
abstract: Statin medications have been suggested for widespread use in patients with systemic lupus erythematosus (SLE). We studied the dose effectiveness and tolerability of pravastatin in SLE. We compared 41 SLE subjects in a two-month open-label dose-titration study of pravastatin to 22 SLE controls. Lipids, ALT, CPK, CRP, adverse effects were assessed. Linear mixed models assessed changes in lipids and CRP, comparing pravastatin subjects to controls. After 1 month of pravastatin 10 mg a day, total cholesterol decreased by 16% (+/-12.1%) and LDL by 24% (+/-17%), compared with 1.8% (+/-7.5%) and 2.6% (+/-8.6%) decreases in controls (P < 0.001). CRP did not decline. Glucocorticoids appeared to decrease pravastatin effectiveness. Serum CPK increased in one subject. Pravastatin reduced LDL and total cholesterol levels approximately the same degree observed in normal individuals, but the effect appeared blunted in those on modest doses of glucocorticoids and those with higher BMI.
authors.affiliation: Division of Rheumatology, Immunology, and Allergy, Section of Clinical Sciences, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA. KCostenbader@partners.org
authors.forename: Karen H
authors.initials: KH
authors.lastname: Costenbader
authors.forename: Matthew H
authors.initials: MH
authors.lastname: Liang
authors.forename: Lori B
authors.initials: LB
authors.lastname: Chibnik
authors.forename: Juliet
authors.initials: J
authors.lastname: Aizer
authors.forename: Hannah
authors.initials: H
authors.lastname: Kwon
authors.forename: Victoria
authors.initials: V
authors.lastname: Gall
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Karlson
mesh_terms: D000328:Adult; D015992:Body Mass Index; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004357:Drug Synergism; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D006937:Hypercholesterolemia / Q000150:complications* / Q000188:drug therapy*; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy; D008875:Middle Aged; D017035:Pravastatin / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D008078:Cholesterol, LDL; D005938:Glucocorticoids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017035:Pravastatin