Department of Rheumatology and Rehabilitation, Tanta Faculty of Medicine, Elgesh Street, Egyt Tanta, 002 Egypt.
J Rheumatol. 2011 Feb;38(2):229-35. doi: 10.3899/jrheum.100582. Epub 2010 Nov 1.
To investigate the effect of atorvastatin therapy on inflammation, disease activity, endothelial dysfunction, and arterial stiffness in patients with rheumatoid arthritis (RA).
This study included 30 patients with early RA, randomly divided into 2 groups. Group 1 (n = 15) received methotrexate (MTX; 0.2 mg/kg/week; mean (15.5 ± SD 1.3) plus prednisone (10 mg/day). Group 2 (n = 15) received MTX and prednisone with the same previous doses plus atorvastatin therapy (40 mg/day). Ten healthy individuals of similar age and sex served as controls. Disease activity, lipid profile, serum malondialdehyde (MDA), tumor necrosis factor-α (TNF-α), resistin, adiponectin, and brachial artery flow-mediated dilation (FMD) were measured before and after 6 months of treatment.
Atorvastatin combined with MTX therapy significantly reduced serum total cholesterol, low-density lipoprotein cholesterol, and triglycerides, and increased high-density lipoprotein cholesterol (p < 0.001). Disease activity variables, serum MDA, TNF-α, resistin, adiponectin, and FMD were significantly improved by the drug combinations (p < 0.001).
Atorvastatin therapy in patients with RA reduced disease activity and conventional and novel vascular risk factors that promote the atheromatous lesion. Therapy was also associated with concomitant improvement in endothelial function.
研究阿托伐他汀治疗对类风湿关节炎(RA)患者炎症、疾病活动度、内皮功能障碍和动脉僵硬的影响。
本研究纳入 30 例早期 RA 患者,随机分为 2 组。第 1 组(n = 15)接受甲氨蝶呤(MTX;0.2 mg/kg/周;均值(15.5 ± SD 1.3)加泼尼松(10 mg/天)。第 2 组(n = 15)接受 MTX 和泼尼松治疗,剂量与之前相同,加用阿托伐他汀治疗(40 mg/天)。10 名年龄和性别相匹配的健康个体作为对照。在治疗前和治疗 6 个月后,测量疾病活动度、血脂谱、血清丙二醛(MDA)、肿瘤坏死因子-α(TNF-α)、抵抗素、脂联素和肱动脉血流介导的扩张(FMD)。
阿托伐他汀联合 MTX 治疗可显著降低血清总胆固醇、低密度脂蛋白胆固醇和甘油三酯,增加高密度脂蛋白胆固醇(p < 0.001)。药物联合治疗可显著改善疾病活动度变量、血清 MDA、TNF-α、抵抗素、脂联素和 FMD(p < 0.001)。
阿托伐他汀治疗 RA 患者可降低疾病活动度以及促进动脉粥样硬化病变的常规和新型血管危险因素。治疗还与内皮功能的同时改善相关。