Simvastatin effects on the disease activity and cholesterol content in blood serum lipoprotein subfractions in patients with rheumatoid arthritis


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Abstract

Aim. To study activity of rheumatoid arthritis (RA) and cholesterol content in subfractions of blood serum lipoproteins in the course of simvastatin treatment. Material and methods. The pilot study enrolled 16 patients with active rheumatoid arthritis (RA) meeting ACR criteria. Any standard anti-RA medication in stable doses was supplemented with simvastatin in a dose 40 mg/day for 12 weeks. The response was assessed by contents of cholesterol in serum lipoprotein subfractions and DAS28 index. Results. At the end of the treatment course there was a significant elevation of HDLP2 and HDLP3 cholesterol and reduction in the levels of LDLP1-3 and LDLP cholesterol. DAS28 decreased by 0.89 points to the end of the treatment. Conclusion. Administration of simvastatin in patients with active RA on standard disease-modulating drugs has an antiatherogenic action and attenuates the disease activity. These pilot data should be confirmed by further large-scale controlled trials.

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Влияние симвастатина на активность болезни и содержание холестерина субфракций липопротеинов сыворотки крови у больных ревматоидным артритом. - Цель исследования. Изучить активность ревматоидного артрита (РА) и содержание холестерина в субфракциях липопротеинов сыворотки крови в динамике при лечении симвастатином. Материалы и методы. В пилотное исследование "до-после" включили 16 больных РА. Основным критерием включения был активный РА, соответствующий критериям Американской коллегии ревматологов, пациенты могли получать любые модифицирующие болезнь препараты в стабильной дозировке. В дополнение к стандартной терапии больным назначался симвастатин в дозе 40 мг ежедневно в течение 12 нед. В динамике оценивали содержание холестерина субфракций сывороточных липопротеинов и индекс активности болезни с 28-суставным счетом (DAS28). Результаты. В конце курса лечения было зарегистрировано статистически значимое повышение содержания холестерина ЛПВП2 и ЛПВП3, снижение содержания холестерина ЛПНП1-3 и ЛПНП. Показатель DAS28 к концу лечения статистически значимо снизился на 0,89 балла. Заключение. Можно предполагать, что использование симвастатина у больных активным РА на фоне приема стандартных модифицирующих болезнь препаратов оказывает антиатерогенное действие и снижает активность болезни. Для подтверждения этих предварительных данных требуется проведение широкомасштабных контролируемых исследований.
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