Expired CME Article

Statin Therapy in Rheumatoid Arthritis

Authors: Karen H. Costenbader, MD, MPH, Jonathan S. Coblyn, MD


Rheumatoid arthritis, a chronic inflammatory polyarthritis that destroys synovial joints, is associated with systemic as well as local inflammation and with an increased risk of cardiovascular disease and death not fully explained by traditional cardiac risk factors. Statins (HMG-coA reductase inhibitors), medications originally designed to lower cholesterol, have been shown to have powerful effects on decreasing cardiovascular mortality rates in the general and high-risk populations. Not all of this protective benefit appears to be mediated by lowered cholesterol levels. Statins also influence multiple steps in the inflammatory process, including leukocyte migration and adhesion, T-cell stimulation, nitric oxide bioavailability, generation of free radicals, and angiogenesis. Recent studies show that statins may provide mild anti-inflammatory benefit in rheumatoid arthritis, in addition to reducing cardiovascular risk.

Key Points

* Rheumatoid arthritis is associated with systemic as well as local inflammation and with increased risk of cardiovascular disease and death not fully explained by traditional cardiac risk factors.

* Statins (HMG-coA reductase inhibitors), medications originally designed to lower cholesterol, have been shown to have powerful effects on decreasing cardiovascular mortality rates in the general and in high-risk populations.

* Statins also influence multiple steps in the inflammatory process, including leukocyte migration and adhesion, T-cell stimulation, nitric oxide bioavailability, generation of free radicals, and angiogenesis.

* Statins may be ideal drugs for rheumatoid arthritis, providing a mild anti-inflammatory effect and reducing cardiovascular risk.

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