Effects of rosuvastatin on subclinical atherosclerosis and arterial stiffness in rheumatoid arthritis: a randomized controlled pilot trial

• Published in: Scandinavian journal of rheumatology 2011-11, Vol.40 (6), p.411-421
• Main Authors: Tam, L-S, Li, EK, Shang, Q, Tomlinson, B, Lee, VW, Lee, KK, Li, M, Kuan, W Pang, Li, TK, Tseung, L, Yip, GWK, Freedman, B, Yu, C-M
• Format: Article
• Language: English
• Subjects: Apolipoproteins B - blood; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - physiopathology; Atherosclerosis (general aspects, experimental research); Atherosclerosis - drug therapy; Atherosclerosis - physiopathology; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Carotid Intima-Media Thickness; Carotid Stenosis - diagnostic imaging; Cholesterol - blood; Disease Progression; Diseases of the osteoarticular system; Double-Blind Method; Female; Fluorobenzenes - therapeutic use; Follow-Up Studies; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Inflammatory joint diseases; Male; Medical sciences; Middle Aged; Pilot Projects; Prospective Studies; Pyrimidines - therapeutic use; Risk Factors; Rosuvastatin Calcium; Severity of Illness Index; Sulfonamides - therapeutic use; Treatment Outcome; Vascular Stiffness - drug effects; Vascular Stiffness - physiology
• ISSN: 0300-9742; 1502-7732
• DOI: 10.3109/03009742.2011.586649

Objective: To ascertain the effect of rosuvastatin on carotid atherosclerosis and arterial stiffness in patients with rheumatoid arthritis (RA). Methods: Fifty RA patients were randomized in a double-blind placebo-controlled trial to receive 10 mg rosuvastatin (n = 24) or placebo (n = 26). Patients were followed prospectively every 3 months for 12 months. Intima-media thickness (IMT), augmentation index (AIx), and subendocardial viability ratio (SEVR) were measured at baseline, 6 and 12 months. Results: Rosuvastatin resulted in statistically significant reductions of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), apolipoprotein B (Apo B), and urate levels vs. placebo. However, rosuvastatin had no significant effect on changes in inflammatory markers, including C-reactive protein (CRP) levels [from 2.9 (1.4-11.0) to 3.1 (0.9-13.3) mg/L in the rosuvastatin group compared with from 5.8 (2.6-14.2) to 4.4 (1.2-12.3) mg/L in the placebo group]. Nonetheless, a significant improvement in the Disease Activity Score (DAS) and a reduction in fibrinogen level was observed at 6 and 12 months compared with baseline in the rosuvastatin group. The treatment group exhibited a significant increase in SEVR (from 157 ± 28% to 163 ± 33% in the rosuvastatin group compared with from 143 ± 18% to 143 ± 26% in the placebo group, p = 0.023), but no significant effect was observed in the changes in IMT and AIx. Conclusion: Our data suggest that rosuvastatin has a modest anti-inflammatory effect in RA patients with low disease activity in terms of reduction in DAS and fibrinogen level. Rosuvastastin may also improve subendocardial perfusion and lower the urate level.