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Lipid lowering effective in inflammatory joint disease

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Patients with inflammatory joint disease (IJD), including rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis, respond as well to statin therapy as those without these conditions, researchers report in a May 10th on-line paper in Arthritis & Rheumatism.

Dr. Anne Grete Semb told Reuters Health by email that patients with IJD have “an increased risk of cardiovascular disease (CV) of the same magnitude as those with diabetes. This high risk patients group is poorly handled and till this date there have been no prospective placebo controlled CV preventive trials in this patient group.”

To examine the situation, Dr. Semb of Diakonhjemmet Hospital, Oslo, Norway and colleagues conducted a post hoc analysis of two prospective CV disease prevention trials. These involved statin treatment of post-MI patients or those with clinically evident coronary heart disease. Atorvastatin (Lipitor, Pfizer) and simvastatin at various doses were the agents employed.

Of the 18889 participants, 199 had rheumatoid arthritis, 46 ankylosing spondylitis, and 35 psoriatic arthritis. They were followed for a median of almost 5 years.

The reductions in atherogenic lipids/lipoprotein components were comparable in patients with and without IJD across the different statin treatments. Moreover high dose (80 mg) atorvastatin induced the highest reductions in both groups.

Both patients with and without IJD had a 20% benefit in the risk of CV disease with atorvastatin 80 mg compared to the other less intensive statin treatments. This continued to be so even after adjusting for considerably different baseline characteristics.

Thus, continued Dr. Semb., “patients with IJD had comparable lipid lowering effects and risk reduction on CV disease to those without IJD after intensive treatment with statins. The IJD patients did not have more side effects compared non-IJD.”

Summing up, Dr. Semb concluded that “There is a huge unmet need for cardiovascular prevention in patients with IJD and our results add knowledge to this issue.”

The work was based on a research fellowship grant from the South Eastern Regional Health Authority of Norway, although the 2 trials examined were sponsored by Pfizer.

Dr. Semb has received speaking fees and honoraria and/or consulting fees from companies including Wyeth/Pfizer as have a number of her co-authors. Three of the co-authors are employees of Pfizer, New York.


Effect of intensive lipid lowering on cardiovascular outcome in patients with and without inflammatory joint disease

Arthritis Rheum 2012.