THE USE OF ATORVASTATIN IN RHEUMATOID ARTHRITIS AND ITS EFFECT ON DAS28 AND ACUTE PHASE REACTANTS

Background: Rheumatoid arthritis is a chronic inflammatory arthopathy associated with rapid onset of clinically significant functional impairment, and is associated with accelerated vascular risk with attendant early mortality and excess morbidity. Atorvastatin the well known anti-dyslipidemic have a plausible bioactivity profile in vitro and in vivo that makes them possible therapeutic agents in rheumatoid arthritis to target both vascular risk and synovial inflammation. Objective: The present study was performed to evaluate the effect of atorvastatin on disease activity score and acute phase reactants (ESR, CRP) in rheumatoid arthritis, apart from their lipid lower properties. Study Design: A prospective, hospital based, open labeled, randomized, case control study in which 100 patients of active rheumatoid arthritis, age group between 20-70 years and both sexes were included. The patients were randomized into cases and controls by lottery method. Cases received 40mg of atorvastatin daily and controls received placebo (vitamin B complex capsules) as an adjuvant to existing disease modifying antirheumatic drugs for 6 months. All were clinically evaluated and disease activity score (DAS), ESR, CRP, lipid profile, LFT were measured at 0 and 6 months. Results: Rheumatoid arthritis patients received atorvastatin showed a significant (p value < 0.05) reduction in ESR and CRP as compared to those who received placebo, but without improving DAS-28 (p > 0.05). Conclusion: Atorvastatin significantly suppressed acute phase variables, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in patients with active rheumatoid arthritis despite ongoing therapy with disease modifying anti-rheumatic drugs without significantly improving DAS-28.