[Possibilities of atorvastatin in complex management of extensive psoriasis in patients with arterial hypertension].
Efficacy and safety of the use of atorvastatin in complex treatment of extensive psoriasis was studied in 63 patients with psoriasis and arterial hypertension (AH). Complex clinical functional examination was carried out at study entry and after 6 months of treatment. Psoriasis severity was evaluated with PASI scale, quality of life with DLQI, PDI and SF 36 questionnaires. Degree of systemic inflammation (IL 10, TNF , hsCRP) and local (TNF , rc TNF , LFA 1) systemic immune inflammation was also assessed. Patients were randomized into either atorvastatin group (20 mg/day, n=48) or standard therapy group (n=15). Initially there was no significant difference between groups in psoriasis severity (PASI 22.2 [13.3; 24.6]) and 22.6 [19.3; 23.6], respectively). Six months of therapy with atorvastatin resulted in significant lowering of PASI (3.6 [1.6;4.8]) compared with 17.0 [15.0; 20.1] in control group, p0.01]); 47.9% of patients achieved PASI -50% in 3 weeks and 95.8% - after 6 months of therapy (0% and 13.3% in control group); 81.3% of patients achieved level of PASI -75% by 6th month of treatment. Positive dynamics of therapy was accompanied with significant improvement of quality of life according to data of PDI and DLQI. After 3 weeks of therapy significant lowering of TNF (from 1.45 [0.6; 1.8] to 1.0 [0.6; 1.4], p<0.05) and hs-CRP (from 5.4 [2.4; 7.1] to 3.3 [2.9; 5.5], p<0.05) took place in atorvastatin group. Antiinflammatory effect of atorvastatin persisted by month 6 (TNF 0.7 [0.4; 1.2] compared with 1.4 [1.3; 1.6] in control group, p0.05); hsCRP (3.1 [2.4; 5.0] 5.5 [2.2; 12.1]) in control group, p<0.05). Significant lowering of local immune inflammation was also occurred in atorvastatin group.Thus therapy with atorvastatin was effective and safe in patients with psoriasis and AH.
Vasiuk
Iu A
IuA
Moscow State Medical Dental University, ul. Delegatskaya 20/1, 127473 Moscow, Russia.
Perlamutrov
Iu N
IuN
Shkol'nik
M N
MN
Shkol'nik
E L
EL
D000069059:Atorvastatin; D001794:Blood Pressure / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D006538:Heptanoic Acids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D011758:Pyrroles / Q000008:administration & dosage / Q000627:therapeutic use*; D011788:Quality of Life; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology; D016896:Treatment Outcome
D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin