Okamoto Hiroshi, Koizumi Kyoko, Kamitsuji Shigeo, Inoue Eisuke, Hara Masako, Tomatsu Taisuke, Kamatani Naoyuki, Yamanaka Hisashi
Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.
J Rheumatol. 2007 May;34(5):964-8. Epub 2007 Apr 15.
To analyze the possible beneficial effects of statins on the disease activity of patients with rheumatoid arthritis (RA) using a database from a large observational cohort study.
We studied a total of 7512 patients enrolled in a single-institute based prospective observational cohort of RA patients (IORRA); their information was collected biannually. In this study, cross-sectional data of 4152 patients (female 83.3%, average age 58.4 yrs) in October 2003 were analyzed (Mann-Whitney U-test).
Among 4152 patients with RA, 279 (6.7%) were taking statins; patients taking statins had lower C-reactive protein (0.85 vs 1.24 mg/dl, respectively) and lower swollen joint counts (1.80 vs 2.55), but more frequently used corticosteroids (2.88 vs 2.40 mg/day) compared to patients not taking statins. Serum cholesterol level was closely related to the use of corticosteroids. Thus, an adjustment with the dose of corticosteroid was conducted; even taking account of the effects of steroids, RA disease activity indicated by patient's assessment for pain, physician's assessment, and swollen joint counts was significantly lower in patients with statins compared to those without.
This study indicates that statins have beneficial effects in reducing RA disease activity in the daily practice of rheumatology.
利用一项大型观察性队列研究的数据库，分析他汀类药物对类风湿关节炎（RA）患者疾病活动度可能产生的有益影响。
我们研究了总共7512名纳入单机构前瞻性RA患者观察性队列（IORRA）的患者；每半年收集一次他们的信息。在本研究中，分析了2003年10月4152名患者（女性占83.3%，平均年龄58.4岁）的横断面数据（曼-惠特尼U检验）。
在4152例RA患者中，279例（6.7%）正在服用他汀类药物；与未服用他汀类药物的患者相比，服用他汀类药物的患者C反应蛋白水平较低（分别为0.85 vs 1.24mg/dl），肿胀关节计数较少（1.80 vs 2.55），但更频繁使用皮质类固醇（2.88 vs 2.40mg/天）。血清胆固醇水平与皮质类固醇的使用密切相关。因此，对皮质类固醇剂量进行了调整；即使考虑到类固醇的影响，服用他汀类药物的患者在疼痛的患者评估、医生评估和肿胀关节计数所表明的RA疾病活动度仍显著低于未服用他汀类药物的患者。
本研究表明，在风湿病的日常实践中，他汀类药物对降低RA疾病活动度具有有益作用。
