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Therapy with statins in patients with refractory rheumatic diseases: a preliminary study

Unidad Regional de Reumatología y Osteoporosis, Hospital Central, San Luis Potosí, Mexico, Departamento de Inmunología Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México

H de la Fuente

Departamento de Inmunología Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México

E Cuevas-Orta

Unidad Regional de Reumatología y Osteoporosis, Hospital Central, San Luis Potosí, Mexico

L Baranda

Departamento de Inmunología Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México

J Cruz-Rizo

Unidad Regional de Reumatología y Osteoporosis, Hospital Central, San Luis Potosí, Mexico

R González-Amaro

Departamento de Inmunología Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México, rgonzale{at}uaslp.mx

We have explored the therapeuticpotentialof statins in patients with differentinflammatory rheumatic diseases refractory to conventional therapy. We found that simvastatin (80mg o.d. for eight days) induced a rapid and significant reduction in proteinuria levels in three systemic lupus erythematosus (SLE) patients. A similar kind of therapy had a marked beneficial effect in a patient with Wegener’s granulomatosis and a patient with erythema nodosum. On the other hand, five patients with rheumatoid arthritis (RA) who received atorvastatin for eight days (20mg/day) showed reduction in C-reactive protein levels and a clinical improvement that was classified as an ACR20 response. Prior to the administrationof statins, all these patients had receivedaggressiveconventionaltherapy with no satisfactory response. A significant reduction in spontaneous apoptosis of peripheral blood lymphocytes and expression of CD69 and HLA-DR was observed in SLE patients after simvastatin therapy. These results prompted us to perform a pilot short-time comparative (simvastatin versus chloroquine) open clinical trial in 15 patients with RA who were receiving methotrexate as a single disease modifying antirheumatic drug with no satisfactory response. Most patients (9/10) who received simvastatin (40mg/day) showed an ACR50 or better response after eight weeks, whereas such a response was not observed in any patient (0/5) treated with chloroquine. Our preliminary results indicate that statins may be an important therapeutic tool for the treatment of inflammatory rheumatic diseases.

Key Words: proteinuria • rheumatoid arthritis • statins • systemic lupus erythematosus • vasculitis

Lupus, Vol. 12, No. 8, 607-611 (2003)
DOI: 10.1191/0961203303lu429oa


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