RT Journal Article SR Electronic T1 Global effects of fluvastatin on the prothrombotic status of patients with antiphospholipid syndrome JF Annals of the Rheumatic Diseases JO Ann Rheum Dis FD BMJ Publishing Group Ltd and European League Against Rheumatism SP 675 OP 682 DO 10.1136/ard.2010.135525 VO 70 IS 4 A1 Chary López-Pedrera A1 Patricia Ruiz-Limón A1 Maria Ángeles Aguirre A1 Nuria Barbarroja A1 Carlos Pérez-Sánchez A1 Paula Buendía A1 Ines-Carmen Rodriguez-García A1 Antonio Rodriguez-Ariza A1 Eduardo Collantes-Estevez A1 Francisco Velasco A1 Munther Khasmahta A1 Maria José Cuadrado YR 2011 UL http://ard.bmj.com/content/70/4/675.abstract AB Objective Numerous mechanisms have been proposed to explain the thrombotic/proinflammatory tendency of antiphospholipid syndrome (APS) patients. Prothrombotic monocyte activation by antiphospholipid antibodies involves numerous proteins and intracellular pathways. The anti-inflammatory, anticoagulant and immunoregulatory effects of statins have been aimed as a therapeutic tool in APS patients. This study delineates the global effects of fluvastatin on the prothrombotic tendency of monocytes from APS patients. Methods Forty-two APS patients with thrombosis and 35 healthy donors were included in the study. APS patients received 20 mg/day fluvastatin for 1 month. Blood samples were obtained before the start, at the end and 2 months after the end of treatment. Results After 1 month of treatment, monocytes showed a significant inhibition of tissue factor, protein activator receptors 1 and 2, vascular endothelial growth factor and Flt1 expression that was related to the inhibition of p38 mitogen-activated protein kinase (MAPK) and nuclear factor kappa B/Rel DNA-binding activity. Proteomic analysis showed proteins involved in thrombotic development (annexin II, RhoA and protein disulphide isomerase) with altered expression after fluvastatin administration. In-vitro studies indicated that the inhibition of 3-hydroxy-3-methylglutaryl coenzyme A reductase by fluvastatin might inhibit protein prenylation and MAPK activation. Conclusion The data from this study support the belief that fluvastatin has multiple profound effects in monocyte activity, which might contribute to thrombosis prevention in APS patients.