title: Effect of ezetimibe plus pravastatin on endothelial dysfunction in patients with systemic lupus erythematosus.
abstract: BACKGROUND
  Patients with systemic lupus erythematosus (SLE) have a higher risk for cardiovascular disease (CVD), not fully explained by the conventional risk factors. These patients have endothelial dysfunction (ED) as an early process of atherosclerosis, which can be reversed with therapy.
  
  
  OBJECTIVE
  To determine the effect of ezetimibe plus pravastatin on endothelial function in patients with SLE after 12 months of treatment.
  
  
  METHODS
  An open study, before and after, which assessed the effect of ezetimibe plus pravastatin treatment, was performed. Twenty two patients (21 women and one man) with diagnosis of SLE were studied, with a mean age 40 ± 5 years. Endothelial dysfunction was evaluated using vascular ultrasound of the brachial artery in order to measure the flow-mediated vasodilation (FMV) basal and after 12 months of treatment with pravastatin 40 mg/day plus ezetimibe 10 mg/day. In addition, a lipid profile: total cholesterol (TC), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), and serum C-reactive protein (CRP), was done.
  
  
  RESULTS
  We found a basal FMV of 7.58% and 18.22% after 12 months of treatment, with an improvement of 10.64 points 95% CI (7.58-13.58), p < 0.001. TC decreased from 201.3 ± 58.9 mg/dL to 158.06 ± 50.13 mg/dL (p < 0.01); LDL-C from 125.78 ± 44.4 mg/dL to 78.8 ± 32.9 mg/dL (p < 0.001); HDL-C increased from 49.0 ± 16.8 mg/dL to 52.2 ± 13.8 mg/dL (p = 0.077). The basal and final concentrations of CRP were 4.49 and 2.8, respectively, with a mean decrease of 2.11 mg/dL, 95% CI (0.908-3.32), p < 0.002. Both drugs were well tolerated.
  
  
  CONCLUSIONS
  Ezetimibe plus pravastatin significantly improved FMV in patients with SLE, decreasing ED and the lipid profile. This treatment ameliorated an early process of atherosclerosis and a risk factor for CVD.
authors.affiliation: Internal Medicine Department, Hospital de Especialidades "Dr Antonio Fraga Mouret", Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico Postgraduate Studies Division, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico olgavera62@yahoo.com.mx.
authors.forename: O
authors.initials: O
authors.lastname: Vera-Lastra
authors.affiliation: Internal Medicine Department, Hospital de Especialidades "Dr Antonio Fraga Mouret", Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico Postgraduate Studies Division, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico.
authors.forename: S
authors.initials: S
authors.lastname: Méndez-Flores
authors.affiliation: Internal Medicine Department, Hospital de Especialidades "Dr Antonio Fraga Mouret", Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico Postgraduate Studies Division, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico.
authors.forename: M P
authors.initials: MP
authors.lastname: Cruz-Dominguez
authors.affiliation: Clinical Research Unit, Hospital de Especialidades "Dr Antonio Fraga Mouret", Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico Postgraduate Studies Division, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico.
authors.forename: G
authors.initials: G
authors.lastname: Medina
authors.affiliation: Cardiology Department, Hospital de Especialidades "Dr Antonio Fraga Mouret", Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: E
authors.initials: E
authors.lastname: Calderón-Aranda
authors.affiliation: Direction of Education and Research, Hospital de Especialidades "Dr Antonio Fraga Mouret", Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico Postgraduate Studies Division, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico.
authors.forename: L J
authors.initials: LJ
authors.lastname: Jara
mesh_terms: D000328:Adult; D000924:Anticholesteremic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D050197:Atherosclerosis / Q000517:prevention & control; D001916:Brachial Artery / Q000000981:diagnostic imaging; D002097:C-Reactive Protein / Q000032:analysis; D002784:Cholesterol / Q000097:blood; D004359:Drug Therapy, Combination; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D000069438:Ezetimibe / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D017035:Pravastatin / Q000008:administration & dosage* / Q000009:adverse effects; D014463:Ultrasonography; D014664:Vasodilation
chemical_list: D000924:Anticholesteremic Agents; D002097:C-Reactive Protein; D002784:Cholesterol; D000069438:Ezetimibe; D017035:Pravastatin
keywords: Endothelial dysfunction; ezetimibe; flow-mediated vasodilation; pravastatin; systemic lupus erythematosus