Statins May Help Rheumatoid Arthritis Symptoms

Large trials of cholesterol drugs still needed

THURSDAY, June 17, 2004 (HealthDayNews) -- A preliminary Scottish study finds that the cholesterol-lowering drugs known as statins can also relieve symptoms of rheumatoid arthritis because they help fight inflammation.

The study, appearing in the June 19 issue of The Lancet, found that patients given daily doses of atorvastatin (Lipitor) had a small but statistically significant improvement in arthritis compared to those given an inactive placebo.

Because it was a small-scale study, including just 116 patients, "we need bigger and more powerful studies" to determine whether statins have a role in the treatment of rheumatoid arthritis, said Dr. Iain B. McInnes, professor of experimental medicine at the University of Glasgow and leader of the trial.

Such studies are "very much in the planning stage" in the United Kingdom, McInnes said.

In the United States, said Dr. John H. Klippel, president and chief executive officer of the Arthritis Foundation, "I have heard of interest in looking at statins in rheumatoid arthritis, but I have no knowledge of ongoing studies."

But two studies of statin treatment for a related condition, lupus erythematosus, have begun, Klippel said.

Like rheumatoid arthritis, lupus is an autoimmune disease in which the body's immune system mistakenly attacks its own tissue. In rheumatoid arthritis, the attack centers on joints, causing inflammation and pain, while a number of organs can be damaged in lupus patients.

In addition to lowering cholesterol levels, statins also appear to reduce inflammation, McInnes said.

"There were two things we were trying to achieve in the study," he said. "One was to test whether statins, which in most people have an anti-inflammatory effect, could influence a condition in which inflammation is a prime mover. The second was based on the recognition that patients with rheumatoid arthritis have an increased risk of vascular diseases such as heart attack and stroke. We wanted to see if we could modify markers of that risk. On both counts, we saw an effect."

The results, while promising, are decidedly preliminary, McInnes said.

"They have not affected treatment day by day," he said. "I would not recommend the use of statins in rheumatoid arthritis on the basis of this study alone."

The goals of the trials of statin treatment in lupus are the same as in the Scottish study, Klippel said -- to relieve inflammatory symptoms of the disease and to reduce the elevated risk of cardiovascular disease in lupus patients.

One reason why statin tests in rheumatoid arthritis have not begun is that a large number of trials of other treatments are under way, Klippel said. For example, British researchers reported Wednesday that infusions of a cancer drug, rituximab, can provide relief of symptoms for as long as 48 weeks. The drug acts on B cells, an important component of the immune system. Rituximab now is being considered as a treatment for lupus and other autoimmune conditions, the researchers said.

More information

All you need to know about rheumatoid arthritis is explained by the Arthritis Foundation.

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