Outcome of rheumatoid arthritis following adjunct statin therapy

Subham Das, Manjushree Mohanty, Prasanta Padhan, Subham Das, Manjushree Mohanty, Prasanta Padhan

Abstract

Objective: Rheumatoid arthritis (RA) is characterized by symmetric peripheral polyarthritis, inflammatory synovitis, and articular destruction. Statins, 3-hydroxy-3-methylglutaryl coenzyme A-reductase inhibitors, mediate significant vascular risk reduction in patients with coronary artery disease by promoting reduction in plasma levels of low-density-lipoprotein cholesterol. Extensive in vitro data, experimental studies and more recently few clinical trials have strongly suggested statins to possess an important role in RA mainly mediated by their anti-inflammatory and immunomodulatory properties. The objective of this study was to evaluate the effect of adjunct statin therapy in comparison to standard disease modifying antirheumatic drugs (DMARD) therapy in patients with RA.

Materials and methods: In this observational study, diagnosed RA patients of age group between 40 and 60 years were selected as per the inclusion criteria from the rheumatology outdoor. From the selected patients, we identified two separate groups of patients. Group 1 included 30 patients of RA currently under DMARD therapy with adjunct statin medication. Group 2 included 30 patients of RA currently under DMARD therapy. Patients were followed up over 6 months. Standard parameters such as disease activity score (DAS28), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were recorded for comparing the outcome of RA in both groups.

Results: Out of a total of 60 patients who took part in the study, significant beneficial role of adjunct statin medication was found in this study when prescribed along with conventional DMARDs in active RA patients. The mean DAS28, considered by far as the most important index of clinical disease activity in RA, was found to be significantly lower (P < 0.05) in the adjunct statin-treated group (group 1) than that of the conventional DMARD treated group (group 2) after 6 months of continuous therapy. Other two important biochemical markers of RA disease activity, that is, ESR and CRP were also found to be significantly lower (P < 0.05) in RA patients who were on adjunct statin medication (group 1) than in group 2 comprising RA patients only under conventional DMARDs therapy without statin medication.

Conclusion: The results suggest an adjunct and potentially beneficial role of statin therapy in active cases of RA, producing significant clinical and biochemical improvement.

Keywords: 3-hydroxy-3-methylglutaryl coenzyme A-reductase inhibitors; disease activity score 28; disease modifying antirheumatic drugs; rheumatoid arthritis; statins.

Figures

Figure 1
Figure 1
Mean levels of erythrocyte sedimentation rate (mm/1st h) in group 1 and group 2 after 6 months of therapy. All values represented as mean ± standard deviation; n = 30, *represents significant difference (P < 0.05) compared by Student's unpaired t-test
Figure 2
Figure 2
Mean levels of C-reactive protein (mg/L) in group 1 and group 2 after 6 months of therapy. All values represented as mean ± standard deviation; n = 30, *represents significant difference (P < 0.05) compared by Student's unpaired t-test
Figure 3
Figure 3
Mean levels of disease activity score 28 in group 1 and group 2 after 6 months of therapy. All values are represented as mean ± standard deviation; n = 30, *represents significant difference (P < 0.05) using Student's unpaired t-test
Figure 4
Figure 4
Line diagram showing change in mean disease activity score 28 values in group 1 and group 2 from baseline to 6 months after therapy. All values represented as mean ± standard deviation

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