TY - JOUR
T1 - Ezetimibe and Simvastatin Reduce Inflammation, Disease Activity, and Aortic Stiffness and Improve Endothelial Function in Rheumatoid Arthritis
AU - Mäki-Petäjä, Kaisa M.
AU - Booth, Anthony D.
AU - Hall, Frances C.
AU - Wallace, Sharon M L
AU - Brown, John
AU - McEniery, Carmel M.
AU - Wilkinson, Ian B.
PY - 2007/8/28
Y1 - 2007/8/28
N2 - Objectives: The aim of this study was to investigate the effect of simvastatin and ezetimibe on inflammation, disease activity, endothelial dysfunction, and arterial stiffness in a cohort of rheumatoid arthritis (RA) patients. Background: Rheumatoid arthritis is a chronic inflammatory condition associated with increased cardiovascular risk. Statins reduce inflammation and disease activity in RA patients, but whether this is due to pleiotropism or cholesterol lowering per se is unclear. Methods: Twenty patients received 20 mg simvastatin or 10 mg ezetimibe each for 6 weeks in a randomized double-blind crossover study. Disease activity, blood pressure, aortic pulse wave velocity (PWV), brachial artery flow-mediated dilation (FMD), and serum inflammatory markers were measured before and after each treatment. Results: Both ezetimibe and simvastatin significantly reduced total cholesterol (-0.62 ± 0.55 mmol/l and -1.28 ± 0.49 mmol/l, respectively; p < 0.001), low-density lipoprotein cholesterol (-0.55 ± 0.55 mmol/l and -1.28 ± 0.49 mmol/l; p < 0.0001), and C-reactive protein (-5.35 ± 9.25 mg/l and -5.05 ± 6.30 mg/l; p < 0.001). Concomitantly, Disease Activity Score (-0.55 ± 1.01 and -0.67 ± 0.91; p = 0.002), aortic PWV (-0.69 ± 1.15 m/s and -0.71 ± 0.71 m/s; p = 0.001), and FMD (1.37 ± 1.17% and 2.51 ± 2.13%; p = 0.001) were significantly improved by both drugs. Conclusions: This study demonstrates that both ezetimibe and simvastatin reduce disease activity and inflammatory markers to a similar extent in patients with RA. Therapy is also associated with a concomitant reduction in aortic PWV and improvement in endothelial function. This suggests that cholesterol lowering per se has anti-inflammatory effects and improves vascular function in RA.
AB - Objectives: The aim of this study was to investigate the effect of simvastatin and ezetimibe on inflammation, disease activity, endothelial dysfunction, and arterial stiffness in a cohort of rheumatoid arthritis (RA) patients. Background: Rheumatoid arthritis is a chronic inflammatory condition associated with increased cardiovascular risk. Statins reduce inflammation and disease activity in RA patients, but whether this is due to pleiotropism or cholesterol lowering per se is unclear. Methods: Twenty patients received 20 mg simvastatin or 10 mg ezetimibe each for 6 weeks in a randomized double-blind crossover study. Disease activity, blood pressure, aortic pulse wave velocity (PWV), brachial artery flow-mediated dilation (FMD), and serum inflammatory markers were measured before and after each treatment. Results: Both ezetimibe and simvastatin significantly reduced total cholesterol (-0.62 ± 0.55 mmol/l and -1.28 ± 0.49 mmol/l, respectively; p < 0.001), low-density lipoprotein cholesterol (-0.55 ± 0.55 mmol/l and -1.28 ± 0.49 mmol/l; p < 0.0001), and C-reactive protein (-5.35 ± 9.25 mg/l and -5.05 ± 6.30 mg/l; p < 0.001). Concomitantly, Disease Activity Score (-0.55 ± 1.01 and -0.67 ± 0.91; p = 0.002), aortic PWV (-0.69 ± 1.15 m/s and -0.71 ± 0.71 m/s; p = 0.001), and FMD (1.37 ± 1.17% and 2.51 ± 2.13%; p = 0.001) were significantly improved by both drugs. Conclusions: This study demonstrates that both ezetimibe and simvastatin reduce disease activity and inflammatory markers to a similar extent in patients with RA. Therapy is also associated with a concomitant reduction in aortic PWV and improvement in endothelial function. This suggests that cholesterol lowering per se has anti-inflammatory effects and improves vascular function in RA.
UR - http://www.scopus.com/inward/record.url?scp=34547950892&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2007.04.076
DO - 10.1016/j.jacc.2007.04.076
M3 - Article
C2 - 17719471
AN - SCOPUS:34547950892
SN - 0735-1097
VL - 50
SP - 852
EP - 858
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 9
ER -