PLEIOTROPIC EFFECTS OF SIMVASTATIN AND FENOFIBRATE IN PATIENTS WITH RHEUMATOID ARTHRITIS: A COMPARATIVE STUDY
https://doi.org/10.15789/1563-0625-2019-1-121-128
Abstract
We compared clinical efficacy and safety of simvastatin (40 mg daily) for 12 weeks (n = 33, group 1) vs fenofibrate (145 mg daily) for 12 weeks (n = 33, group 2) in patients with active RA taking stable doses of DMARDs. Changes in the Disease Activity Score (DAS28) with 28 joints count was the primary endpoint. Both simvastatin and fenofibrate treatment resulted in statistically significant decrease in DAS28 scores, the patients taking fenofibrate developed moderate EULAR and ACR20 responses 1.5 times more frequently than the patients taking simvastatin. There were no serious adverse events in either group. Clinical response was associated with pleiotropic effects, both in simvastatin- and fenofibrate-treated groups. Both drugs resulted in decrease of atherosclerosis immunological markers (CRP and IL-6 levels). At the end of treatment, we observed a decrease in serum IL-17 in patients taking simvastatin. No changes in serum IL-8, TNFα, and IFNγ were observed in both groups. The total cholesterol concentrations did not change, whereas simvastatin treatment resulted in decreased serum LDL cholesterol, while increasing serum HDL cholesterol levels. There was a decrease of triglyceride concentrations in patients taking fenofibrate. In conclusion, simvastatin and fenofibrate can be considered as drugs of choice in RA patients with high risk of atherosclerosis who do not respond to conventional DMARDs. There is a need for larger comparative studies, in order to define detailed guidelines for their use.
About the Authors
I. V. Shirinsky
Institute of Fundamental and Clinical Immunology
Russian Federation
Russian Federation
PhD, MD (Medicine), Leading Research Associate, Laboratory of Clinical Immunopharmacology
630047, Russian Federation, Novosibirsk, Yadrintsevskaya str., 14.
Phone: 7 (923) 107-51-00. Fax: 7 (383) 228-25-47.
N. Yu. Kalinovskaya
Institute of Fundamental and Clinical Immunology
Russian Federation
Russian Federation
PhD (Medicine), Laboratory Research Assistant, Laboratory of Clinical Immunopharmacology
Novosibirsk
V. S. Shirinsky
Institute of Fundamental and Clinical Immunology
Russian Federation
Russian Federation
PhD, MD (Medicine), Professor, Head, Laboratory of Clinical Immunopharmacology
Novosibirsk
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Review
For citations:
Shirinsky I.V., Kalinovskaya N.Yu., Shirinsky V.S. PLEIOTROPIC EFFECTS OF SIMVASTATIN AND FENOFIBRATE IN PATIENTS WITH RHEUMATOID ARTHRITIS: A COMPARATIVE STUDY. Medical Immunology (Russia). 2019;21(1):121-128. (In Russ.) https://doi.org/10.15789/1563-0625-2019-1-121-128
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