Background There are some data indicating that statins produce a pleiotropic effect and can increase bone mineral density. It is also known that some statins (pravastatin, simvastatin) have an anti-inflammatory effect. Simvastatin has been shown to be effective in the treatment of rheumatoid arthritis (RA) in humans. We failed to find any research data indicating that atorvastatin has anti-inflammatory effects.
Objectives To study the effect of Atorvastatin on the dynamics of bone mineral density and inflammatory markers of osteoporosis (OP) in patients with RA.
Methods We examined 170 RA patients aged 22 – 75 years (128 females (75.3%) and 42 males (24.7%)). Bone mineral density was measured with dual-energy X-ray absorptiometry (DEXA) (Lunar DPX-Pro, GE, USA). Additionally, we measured serum osteocalcin levels and urine CrossLaps with ELISA test.
We divided the patients into two groups to study the effectiveness of Atorvastatin in the treatment of patients with RA/OP and osteopenia. Group 1 included 38 individuals who received Atorvastatin for 6 months at a dose of 20–40 micrograms per day. The experimental group included 29 patients with OP and osteopenia. They received calcium supplements at a dose of 1000 mg per day.
Results We revealed that 84 (51.5%) out of 170 patients with RA had significantly lower Z- and T-scores values. We noted that 17 (20.2%) patients were diagnosed as having osteoporosis, while 67 (79.8%) had osteopenia. The most common manifestations of OP in RA patients included fractures, bone and back pain, as well as decreased muscle strength.
We measured biochemical markers of bone turnover at baseline and after 6-month of the treatment. There was significant positive dynamic of clinical and laboratory parameters during a 6-month treatment with Atorvastatin in OP patients with RA. In this patients we observed BMD and muscle strength increasing, reducing of bone and back pain, decreasing of C-reactive protein. Urinary CrossLaps were significantly decreased. Atorvastatin was well tolerated. There were few of insignificant side effects which were reduced after the drug dose decreasing. Symptomatic improvement occurred within 2–3 months after starting of atorvastatin therapy. Second group patients who received calcium monotherapy showed signs of progressive OP: bone mineral density continued to decrease (mean -2.7±0.18%), while bone pain and biochemical markers of bone metabolism remained unchanged.
Conclusions We concluded that Atorvastatin may be used in the treatment of RA patients and can help to stabilize bone mineral density and improve the OP symptoms.
Disclosure of Interest None declared
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