Article Text

PDF
Concise report
A prospective open-label pilot study of fluvastatin on proinflammatory and prothrombotic biomarkers in antiphospholipid antibody positive patients
  1. Doruk Erkan1,
  2. Rohan Willis2,
  3. Vijaya L Murthy2,
  4. Gurjot Basra2,
  5. JoAnn Vega1,
  6. Patricia Ruiz-Limón2,
  7. Ana Laura Carrera2,
  8. Elizabeth Papalardo2,
  9. Laura Aline Martínez-Martínez2,
  10. Emilio B González2,
  11. Silvia S Pierangeli2
  1. 1Barbara Volcker Center for Women and Rheumatic Diseases, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY, USA
  2. 2Division of Rheumatology/Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
  1. Correspondence to Dr Silvia S Pierangeli, Division of Rheumatology/Internal Medicine, University of Texas Medical Branch, Brackenridge Hall 2.108, 301 University Boulevard, Galveston, TX 77555-0883, USA; sspieran{at}utmb.edu

Abstract

Objective To determine if proinflammatory and prothrombotic biomarkers are differentially upregulated in persistently antiphospholipid antibody (aPL)-positive patients, and to examine the effects of fluvastatin on these biomarkers.

Methods Four groups of patients (age 18–65) were recruited: (a) primary antiphospholipid syndrome; (b) systemic lupus erythematosus (SLE) with antiphospholipid syndrome (APS) (SLE/APS); (c) persistent aPL positivity without SLE or APS (Primary aPL); and (d) persistent aPL positivity with SLE but no APS (SLE/aPL). The frequency-matched control group, used for baseline data comparison, was identified from a databank of healthy persons. Patients received fluvastatin 40 mg daily for 3 months. At 3 months, patients stopped the study medication and they were followed for another 3 months. Blood samples for 12 proinflammatory and prothrombotic biomarkers were collected monthly for 6 months.

Results Based on the comparison of the baseline samples of 41 aPL-positive patients with 30 healthy controls, 9/12 (75%) biomarkers (interleukin (IL)-6, IL1β, vascular endothelial growth factor (VEGF), tumour necrosis factor (TNF)-α, interferon (IFN)-α, inducible protein-10 (IP10), soluble CD40 ligand (sCD40L), soluble tissue factor (sTF) and intracellular cellular adhesion molecule (ICAM)-1) were significantly elevated. Twenty-four patients completed the study; fluvastatin significantly and reversibly reduced the levels of 6/12 (50%) biomarkers (IL1β, VEGF, TNFα, IP10, sCD40L and sTF).

Conclusions Our prospective mechanistic study demonstrates that proinflammatory and prothrombotic biomarkers, which are differentially upregulated in persistently aPL-positive patients, can be reversibly reduced by fluvastatin. Thus, statin-induced modulation of the aPL effects on target cells can be a valuable future approach in the management of aPL-positive patients.

  • Antiphospholipid Antibodies
  • Antiphospholipid Syndrome
  • Inflammation
  • Treatment
  • Cytokines

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.