title: Evaluation of the Anti-inflammatory Effects of Atorvastatin on Patients with Rheumatoid Arthritis: A Randomized Clinical Trial.
abstract: BACKGROUND
  Rheumatoid arthritis (RA) is a chronic inflammatory joint disorder with unknown etiology. Atorvastatin is a lipid-lowering agent that affects the inflammatory processes.
  
  
  OBJECTIVE
  This study aimed to determine the anti-inflammatory effects of atorvastatin on the Disease Activity Index and high-density lipoprotein (HDL) concentrations in RA patients.
  
  
  METHODS
  This clinical trial was performed on 38 RA patients, who were referred to the Imam Reza and Ghaem Medical Centers of Mashhad, Iran between 2013 and 2014. Patients were divided into two groups: 1) the intervention group, which received 40 mg of atorvastatin, and 2) the control group. Response to treatment and the clinical status of patients were evaluated using the Disease Activity Score (DAS-28) and Visual Analogue Scale (VAS) at weeks zero, four, eight, and twelve, based on the 2010 ACR/EULAR Criteria by two rheumatologists. Disease activity and laboratory parameters, including erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP), DAS-ESR, DAS- hs-CRP, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and liver function test (LFT) were measured in both groups.
  
  
  RESULTS
  There was a significant difference in the mean number of swollen joints (p<0.011), ESR (p <0.005), DAS-ESR (P<0.043), LDL (0.036), and HDL (0.016) between the two groups. The changes in trend showed no significant difference in the mean number of tender joints (p =0.38), VAS (p =0.715), CRP (p =0.07), DAS-hs-CRP (p=0.431), total cholesterol (p=0.285), or TG (p =0.331) between the two groups. However, the Disease Activity Index decreased by 48.4% in the intervention group, compared to 35.5% in the control group.
  
  
  CONCLUSIONS
  As the results indicated, atorvastatin has a positive effect on the course of RA. In fact, atorvastatin, as an anti-inflammatory agent, could significantly influence inflammation in RA patients. Therefore, adding a lipid-lowering agent to standard medications in RA may be warranted and could decrease disease activity.
  
  
  BACKGROUND
  The trial was registered at the Iranian Registry of Clinical Trials (Website: http://www.irct.ir, Irct ID: IRCT2015122425648N2).
  
  
  BACKGROUND
  The authors received no financial support for the research, authorship, and/or publication of this article.
authors.affiliation: Associate Professor, Rheumatology Department, Rheumatic Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Zhaleh Shariati
authors.initials: ZS
authors.lastname: Sarabi
authors.affiliation: Assistant Professor, Rheumatology Department, North Khorasan University of Medical Sciences, Bojnord, Iran.
authors.forename: Mehran Ghazi
authors.initials: MG
authors.lastname: Saeidi
authors.affiliation: Assistant Professor, Rheumatology Department, Rheumatic Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mandana
authors.initials: M
authors.lastname: Khodashahi
authors.affiliation: BSc (Honored), MSc, Medical Student of Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
authors.forename: Ali Etemad
authors.initials: AE
authors.lastname: Rezaie
authors.affiliation: Assistant Professor, Rheumatology Department, Rheumatic Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Kamila
authors.initials: K
authors.lastname: Hashemzadeh
authors.affiliation: Infectious Disease Resident, Department of Infectious Diseases. Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Rozita
authors.initials: R
authors.lastname: Khodashahi
authors.affiliation: Medical Student, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Heidari
keywords: Anti-inflammatory; Atorvastatin; Rheumatoid arthritis