Statins would be effective against cardiovascular problems in patients with rheumatoid arthritis, without additional risk.
Rheumatoid arthritis is a chronic, inflammatory joint disease of autoimmune origin. Patients affected by this condition have an approximately 50% higher risk of experiencing cardiovascular events, such as heart attack or stroke, compared to the general population.
By lowering LDL cholesterol, statins are known to help prevent cardiovascular events in some high-risk individuals, but whether they are safe and effective for patients with inflammatory conditions such as rheumatoid arthritis is unknown. Researchers have looked into this question and published their results in Arthritis & Rheumatology, an official journal of the American College of Rheumatology.
To investigate the potential risks and benefits of statins in patients with rheumatoid arthritis, researchers designed a multicenter study, which compared atorvastatin (a statin-like drug) to placebo. More than 3,000 patients participated: they either had rheumatoid arthritis and were over 50 years old, or had rheumatoid arthritis for over 10 years, without clinical atherosclerosis, diabetes or myopathy. Patients either received atorvastatin 40 mg daily or a placebo.
Results: a risk reduced by 10%
During a follow-up two and a half years, 1.6% of patients who received atorvastatin and 2.4% of patients in the placebo group experienced cardiovascular death, heart attack, stroke, transient ischemic attack, or arterial revascularization. After adjustment, we can say that the risk of cardiovascular events decreases by 40% in patients treated with atorvastatin, although the difference was not statistically significant, as the overall event rate was low. At the end of the trial, patients treated with atorvastatin had significantly lower LDL cholesterol levels and significantly lower levels of C-reactive protein, a marker of inflammation, than those treated with placebo. Adverse effects observed in the atorvastatin and placebo groups were similar.
The authors of the study recommend prescribing statins patients with rheumatoid arthritis in accordance with national or local guidelines for cardiovascular risk management in the general population. “The results show that there is no greater risk of taking statins if you have rheumatoid arthritis,” said Professor Deborah Symmons, one of the two lead authors.
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