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A pravastatin dose-escalation study in systemic lupus erythematosus
Karen H Costenbader1, Matthew H Liang, Lori B Chibnik
1Division of Rheumatology, Immunology, and Allergy, Section of Clinical Sciences, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA. KCostenbader@partners.org
Rheumatology International
|April 4, 2007
Summary
Pravastatin effectively lowers cholesterol in patients with systemic lupus erythematosus (SLE), though its effectiveness may be reduced by glucocorticoid use and higher BMI. Further research is needed for optimal statin therapy in SLE.
Area of Science:
- Rheumatology
- Cardiovascular Medicine
- Pharmacology
Background:
- Systemic lupus erythematosus (SLE) patients may benefit from statin medications.
- The efficacy and tolerability of pravastatin in SLE require further investigation.
Purpose of the Study:
- To evaluate the dose-effectiveness and tolerability of pravastatin in SLE patients.
- To compare lipid changes and C-reactive protein (CRP) levels in SLE patients treated with pravastatin versus controls.
Main Methods:
- A two-month open-label, dose-titration study of pravastatin involving 41 SLE patients.
- Comparison with 22 SLE control subjects.
- Assessment of lipids, ALT, CPK, CRP, and adverse effects; analysis using linear mixed models.
Main Results:
- Pravastatin significantly reduced total cholesterol (16%) and LDL (24%) after one month (P < 0.001).
- No significant decrease in CRP was observed.
- Effectiveness was potentially blunted by glucocorticoid use and higher BMI; one patient experienced CPK elevation.
Conclusions:
- Pravastatin demonstrates effectiveness in reducing cholesterol levels in SLE patients, similar to general populations.
- Concomitant glucocorticoid use and higher BMI may diminish pravastatin's lipid-lowering effects in SLE.
- Pravastatin appears generally well-tolerated, with careful monitoring recommended.
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