title: Lupus Atherosclerosis Prevention Study (LAPS).
abstract: BACKGROUND
  Cardiovascular disease is one of the major causes of death in systemic lupus erythematosus (SLE). A study was undertaken to investigate whether treatment with statins would reduce subclinical measures of atherosclerosis over a 2-year period.
  
  
  METHODS
  200 patients with SLE without clinical cardiovascular disease were randomised to receive atorvastatin 40 mg daily or an identical placebo. At baseline and after 2 years of follow-up, helical CT scanning (for coronary artery calcium) and carotid duplex (for intima media thickness/plaque) were performed. Patients were seen for measures of disease activity at 1 month, 3 months and quarterly thereafter. The primary outcome variable was change in coronary artery calcium.
  
  
  RESULTS
  At baseline, 43% had coronary artery calcium. At 2 years there was no significant difference between the groups in progression of coronary artery calcium, carotid intima media thickness or carotid plaque. There was no significant difference between the groups in disease activity, measures of inflammation or endothelial cell activation.
  
  
  CONCLUSIONS
  This study provides no evidence that atorvastatin reduces subclinical measures of atherosclerosis or disease activity over 2 years in patients with SLE. In fact, it does not appear to reduce biochemical measures of inflammation. The anti-inflammatory effects of statins observed in the general population were not replicated in this SLE clinical trial. Clinicaltrials.gov (NCT 00120887).
authors.affiliation: Professor of Medicine, Johns Hopkins University, 1830 East Monument Street Suite 7500, Baltimore, MD 21205, USA. mpetri@jhmi.edu
authors.forename: M A
authors.initials: MA
authors.lastname: Petri
authors.forename: A N
authors.initials: AN
authors.lastname: Kiani
authors.forename: W
authors.initials: W
authors.lastname: Post
authors.forename: L
authors.initials: L
authors.lastname: Christopher-Stine
authors.forename: L S
authors.initials: LS
authors.lastname: Magder
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000209:etiology / Q000517:prevention & control*; D000069059:Atorvastatin; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000517:prevention & control; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000517:prevention & control; D004311:Double-Blind Method; D005260:Female; D006538:Heptanoic Acids / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin