title: Atorvastatin, etidronate, or both in patients at high risk for atherosclerotic aortic plaques: a randomized, controlled trial.
abstract: BACKGROUND
  Statins are not effective in reducing atherosclerotic plaques of the abdominal aorta, and accumulating evidence suggests that bisphosphonates have the potential to induce the regression of atherosclerotic plaques of the abdominal aorta.
  
  
  RESULTS
  A prospective, randomized, open-label, blinded-end-point trial involving 108 participants with hypercholesterolemia was conducted. Participants received 20 mg atorvastatin daily, 400 mg etidronate daily, or both drugs daily. The primary end point was the percent change in maximal vessel wall thickness of atherosclerotic plaques in the thoracic and abdominal aortas as measured by magnetic resonance imaging after 12 months of treatment. In both the combination therapy and atorvastatin groups, maximal vessel wall thickness of the thoracic aorta was reduced by 13.8% (95% confidence interval, -16.4 to -11.3) and 12.3% (95% confidence interval, -14.9 to -9.7), respectively. These reduction rates were comparable between groups (P=0.61). Meanwhile, in the etidronate group, maximal vessel wall thickness of the thoracic aorta remained unchanged (2.2%; 95% confidence interval, -0.3 to 4.8). Conversely, maximal vessel wall thickness of the abdominal aorta was reduced more effectively in the combination therapy group (-11.4%) than in the atorvastatin group (-0.9%; P<0.001) and the etidronate group (5.5%; P=0.006).
  
  
  CONCLUSIONS
  Atorvastatin plus etidronate combination therapy for 12 months significantly reduced both thoracic and abdominal aortic plaques, whereas atorvastatin monotherapy reduced only thoracic aortic plaques and etidronate monotherapy reduced only abdominal aortic plaques. The effectiveness of combination therapy in reducing atherosclerotic plaques in the abdominal aorta was significantly greater than for both atorvastatin and etidronate monotherapy.
  
  
  BACKGROUND
  URL: http://www.umin.ac.jp/ctr/. Unique identifier: UMIN 000002635.
authors: Division of Endocrinology and Metabolism, Department of Internal Medicine, Niigata Rosai Hospital, 1-7-12 Touncho, Joetsu, Niigata 942-8502, Japan. k-tetsuy@niirou.jp
authors: Tetsuya
authors: T
authors: Kawahara
authors: Masako
authors: M
authors: Nishikawa
authors: Chie
authors: C
authors: Kawahara
authors: Tetsuya
authors: T
authors: Inazu
authors: Kunio
authors: K
authors: Sakai
authors: Gen
authors: G
authors: Suzuki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000473:pathology; D001013:Aorta, Thoracic / Q000473:pathology; D001018:Aortic Diseases / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D000069059:Atorvastatin; D015519:Bone Density / Q000187:drug effects; D002114:Calcinosis / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D012968:Etidronic Acid / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009928:Organ Specificity; D058226:Plaque, Atherosclerotic / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D011446:Prospective Studies; D011758:Pyrroles / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin; D012968:Etidronic Acid
keywords: atherosclerosis; disphosphonates; plaque, atherosclerotic; statins; vascular calcification