Patients with rheumatoid arthritis (RA) and other inflammatory joint diseases may be able to reduce their risk of carotid artery disease, a dangerous cardiovascular condition, with treatment with statin drugs.
People with RA have a higher risk than the general public of developing a condition known as carotid artery disease. This condition occurs when fatty substances and cholesterol deposits (plaque) build up in the arteries (blood vessels) in the neck, the carotid arteries. The plaque buildup narrows and can even completely block the arteries. When this happens, blood flow to the heart is reduced or stopped, which is a very serious, often life-threatening condition. In spite of the increased risk of carotid artery disease among people with RA, there hasn’t been extensive research into treatment for these patients.
Individuals in the general population who have a buildup of plaque in their carotid arteries are often treated with drugs to lower cholesterol levels known as statins. Researchers recently performed a study to determine how well statin treatment would help reduce carotid artery plaque accumulation in people with RA as well as other inflammatory conditions.
Eighty-six patients, who had RA and other inflammatory joint diseases as well plaques in their carotid arteries, participated in the study. They were treated with the statin drug Crestor® (rosuvastatin) with the goal of lowering cholesterol and plaque levels. The researchers used ultrasound to measure plaque levels (which are measured in height).
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After 18 months of taking Crestor, patients overall had a significant reduction in carotid plaque height. They also had lower cholesterol levels overall.
Markers of inflammation associated with RA and other inflammatory joint conditions (such as C-reactive protein) didn’t decrease consistently during the study period. Patients with the highest levels of disease activity appeared to benefit the least from statin treatment—they had the least change in plaque height.
The types of treatment patients were receiving for RA or other inflammatory diseases appeared to affect their response to statin treatment. Patients on biologics didn’t have a significant reduction in plaque height, while those on disease-modifying antirheumatic drugs (DMARDs) on the greatest decrease. Patients who weren’t on biologics or DMARDs had a slightly smaller decrease in plaque levels than those on DMARDs.
Treatment with statin drugs appears to help lower cholesterol and plaque levels in patients with RA and other inflammatory joint diseases. As this was the first study to show that statins could help prevent carotid artery disease in these patients, the researchers feel that additional study of this approach is worthwhile.
Reference: Rollefstad S, Ikdahl E, Hisdal J, et al. Rosuvastatin-Induced Carotid Plaque Regression in Patients With Inflammatory Joint Diseases: The Rosuvastatin in Rheumatoid Arthritis, Ankylosing Spondylitis and Other Inflammatory Joint Diseases Study. Arthritis & Rheumatology. 26 June 2015 DOI: 10.1002/art.39114