Effect of Atorvastatin on the Disease Activity and Severity of Rheumatoid Arthritis: Double-Blind Randomized Controlled Trial

Abstract

Introduction: HMG-CoA (3-hydroxy-3- methylglutary lcoenzyme A) reductase inhibitors (statins) have anti-inflammatory properties which may be particularly useful in rheumatoid arthritis to suppress disease activity and inflammatory factors.

Aim: The purpose of this clinical trial was to determine anti-inflammatory properties of statins in rheumatoid arthritis.

Materials and methods: Eighty Iranian patients with rheumatoid arthritis, aged between 19 to 75 years were recruited to take part in this randomized, double-blind placebo-controlled trial. Subjects were randomly allocated to two groups to take atorvastatin or placebo 40 mg daily as an adjunct to current disease-modifying anti-rheumatic drugs (DMARDs) treatment. Disease Activity Score-28 (DAS28), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), swollen joint count (SJC) & tender joint count (TJC) were assessed before and after three months intervention.

Results: Analysis was based on intention to treat. DAS28 significantly declined in the atorvastatin group in comparison with placebo (p< 0.001). SJC, TJC, CRP and ESR also were significantly dropped in the atorvastatin group in comparison with placebo.

Conclusion: It can be concluded that atorvastatin can suppress RA activity and inflmmatory factors in RA patients for high to moderate grade of inflmmation.

Keywords: Anti-inflammatory agents; Erythrocyte sedimentation rate; HMG-CoA; Swollen joint count; Tender joint count.

Figures

[Table/Fig-1]:

CONSORT flow chart of subjects’ recruitment process for 2-group parallel randomized trial. ITT, intention to treat.

[Table/Fig-3]:

Comparison of mean of DAS28 in patients with rheumatoid arthritis before and after 3 months intervention among two groups; statin (n=40), placebo (n=40).

[Table/Fig-4]:

Trends of mean DAS28 in patients with rheumatoid arthritis before and after 3 months intervention among two groups; statin (n=40), placebo (n=40).

[Table/Fig-5]:

Classifications of DAS28 in patients with rheumatoid arthritis before and after 3 months intervention among two groups; statin (n=40), placebo (n=40).

[Table/Fig-6]:

Classifications of C-reactive protein (CRP) in patients with rheumatoid arthritis before and after 3 months intervention among two groups; statin (n=40) placebo (n=40).