THE USE OF STATINS IN THE COMPLEX TREATMENT OF PATIENTS WITH RHEUMATOID ARTHRITIS
Fedorovych K.M., Yatsyshyn R.I.
Summary. Background. Rheumatoid arthritis (RA) is a chronic autoimmune disorder which is typically characterized by progressive inflammatory damage of the joints, leading to their deformity. As inflammation occupies a prominent place in its pathogenesis, it is an indispensable target for the RA treatment strategies. Aim. The objective of this study was to evaluate the possible anti-inflammatory influence of statins therapy on RA patients. Methods. 80 patients with confirmed, according to 2010 ACR/EULAR Classification Criteria, RA diagnosis were enrolled into our study. The inclusion criteria were the age of patients ≥18 years and the DAS-28 index >2,6. Individuals with any prior medical history of myopathies, liver diseases or increased transaminase levels, pregnant or breastfeeding women and patients taking lipid-lowering drugs were excluded from the study. We randomized all our patients into 2 groups, 40 individuals each. The first group of subjects received just basic DMARDs and the second had atorvastatin 40 mg/day in addition. The admission of atorvastatin lasted 3 months. We evaluated the ESR, CRP, Visual Analogue Scale (VAS), swollen joint count (SJC), tender joint count (TJC) and Disease Activity Score (DAS-28). Furthermore, we assessed the lipid profile in both groups of patients. Results. The administration of atorvastatin in a complex therapy of RA had a benefitial effect on pro-inflammatory indicies of our patients. In the first group the levels of ESR (mm/h) and CRP (mg/L) were significantly lower in comparison with the controls (25.38±9.43 vs 31.85±10.54, p<0.05 and 12.26 [8.21–17.54] vs 15.89 [11.32–21.54], p=0.04 respectively). SJC (p<0.05) and TJC (p<0.05) and DAS-28 (p<0.05) parameters have been improved more significantly in the atorvastatin group as well. The assessment of lipid profile showed better results in the investigation group as well. The LDL (mg/dl) level differed between the two groups the most significantly (143.7±23.2 in the control group and 109.8±21.4 in the atorvastatin group, p<0.01). Conclusions. This study reveals the positive effect of atorvastatin on the lipid profile, inflammatory indices and disease course in patients with RA.
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