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AB0601 Effect of Pravastatin Plus Ezetimibe on Carotid Intima-Media Thickness in Patients with Systemic Lupus Erythematosus
  1. O. Vera-Lastra,
  2. A. Olvera,
  3. M.D.P. Cruz Dominguez,
  4. G. Medina,
  5. L.J. Jara
  1. Internal Medicine, Hospital Especialidades CMN La Raza. Instituto Mexicano Seguro Social, Mexico City, Mexico

Abstract

Background Patients with systemic lupus erythematosus (SLE) have accelerated atherosclerosis that can be assessed by the carotid intima media thickness (CIMT) measurement. A prompt hypolipidemic treatment should be a part of the integral management

Objectives To determine the effect of therapy with pravastatin plus ezetimibe on the CIMT in SLE patients.

Patients and Methods Longitudinal, prospective, quasi-experimental trial. Out of 60 SLE patients in whom a carotid ultrasound was performed, we chose 22 with a CIMT >0.7 mm who were administered pravastatin plus ezetimibe during 6 months with determination of CIMT at the end of the study. We performed the following tests: total cholesterol (TC), HDL-cholesterol, LDL-cholesterol, tryglicerides, C-reactive protein (CRP), liver function, muscle enzimes and glucose, basal and at the end of treatment. Statistical analysis: Descriptive statistics and Wilcoxon test were used.

Results There were 22 women with an age of 42±6.3 years, average disease evolution 7.5±6.6 years, of whom, 18 concluded the study. Right basal CIMT was 0.829±0.1448 vs. final 0.688±0.1453, p<0.003; left CIMT was 0.820±0.1312 vs. 0.724±0.1348, p<0.004. Only 3 patients had atherosclerotioc plaques, 2 with an evolution of SLE less than 3 years. TC 208mg/dl vs 168mg/dl, LDL-C 125mg/dl vs. 72mg/dl, p=0.0004. CRP 3.12 vs 2.25 p=0.004. In 2 cases there were gastrointestinal, skin and muscle adverse effects.

Conclusions Treatment with pravastatin plus ezetimibe decreases the CIMT with improvement in the concentration of total cholesterol, LDL-C and CRP levels with good toleration.

References

  1. Petri MA, Kiani AN, Post W, Christopher-Stine L, Magder LS. Lupus Atherosclerosis Prevention Study (LAPS). Ann Rheum Dis. 2011;70(5):760-5

  2. Manzi S, Selzer F, Sutton-Tyrrell K, Fitzgerald SG, Rairie JE, Tracy RP, et al. Prevalence and risk factors of carotid plaque in women with systemic lupus erythematosus. Arthritis Rheum. 1999;42:51-60.

  3. Riboldi P, Gerosa M, Moroni PL. Statins and autoinmune diseases. Lupus 2005;14:765-68.

Disclosure of Interest None declared

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