title: Outcome of rheumatoid arthritis following adjunct statin therapy.
abstract: OBJECTIVE
  Rheumatoid arthritis (RA) is characterized by symmetric peripheral polyarthritis, inflammatory synovitis, and articular destruction. Statins, 3-hydroxy-3-methylglutaryl coenzyme A-reductase inhibitors, mediate significant vascular risk reduction in patients with coronary artery disease by promoting reduction in plasma levels of low-density-lipoprotein cholesterol. Extensive in vitro data, experimental studies and more recently few clinical trials have strongly suggested statins to possess an important role in RA mainly mediated by their anti-inflammatory and immunomodulatory properties. The objective of this study was to evaluate the effect of adjunct statin therapy in comparison to standard disease modifying antirheumatic drugs (DMARD) therapy in patients with RA.
  
  
  METHODS
  In this observational study, diagnosed RA patients of age group between 40 and 60 years were selected as per the inclusion criteria from the rheumatology outdoor. From the selected patients, we identified two separate groups of patients. Group 1 included 30 patients of RA currently under DMARD therapy with adjunct statin medication. Group 2 included 30 patients of RA currently under DMARD therapy. Patients were followed up over 6 months. Standard parameters such as disease activity score (DAS28), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were recorded for comparing the outcome of RA in both groups.
  
  
  RESULTS
  Out of a total of 60 patients who took part in the study, significant beneficial role of adjunct statin medication was found in this study when prescribed along with conventional DMARDs in active RA patients. The mean DAS28, considered by far as the most important index of clinical disease activity in RA, was found to be significantly lower (P < 0.05) in the adjunct statin-treated group (group 1) than that of the conventional DMARD treated group (group 2) after 6 months of continuous therapy. Other two important biochemical markers of RA disease activity, that is, ESR and CRP were also found to be significantly lower (P < 0.05) in RA patients who were on adjunct statin medication (group 1) than in group 2 comprising RA patients only under conventional DMARDs therapy without statin medication.
  
  
  CONCLUSIONS
  The results suggest an adjunct and potentially beneficial role of statin therapy in active cases of RA, producing significant clinical and biochemical improvement.
authors.affiliation: Department of Pharmacology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
authors.forename: Subham
authors.initials: S
authors.lastname: Das
authors.affiliation: Department of Pharmacology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
authors.forename: Manjushree
authors.initials: M
authors.lastname: Mohanty
authors.affiliation: Department of Rheumatology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
authors.forename: Prasanta
authors.initials: P
authors.lastname: Padhan
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D018771:Arthralgia / Q000209:etiology / Q000517:prevention & control; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation / Q000187:drug effects; D002097:C-Reactive Protein / Q000032:analysis; D015536:Down-Regulation / Q000187:drug effects; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007596:Joints / Q000187:drug effects / Q000276:immunology; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010147:Pain Measurement; D011446:Prospective Studies; D012720:Severity of Illness Index
chemical_list: D018501:Antirheumatic Agents; D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002097:C-Reactive Protein
keywords: 3-hydroxy-3-methylglutaryl coenzyme A-reductase inhibitors; disease activity score 28; disease modifying antirheumatic drugs; rheumatoid arthritis; statins