PLEIOTROPIC EFFECTS OF SIMVASTATIN AND FENOFIBRATE IN PATIENTS WITH RHEUMATOID ARTHRITIS: A COMPARATIVE STUDY

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 prima...

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Autores principales:	I. V. Shirinsky, N. Yu. Kalinovskaya, V. S. Shirinsky
Formato:	article
Lenguaje:	RU
Publicado:	SPb RAACI 2019
Materias:	rheumatoid arthritis simvastatin fenofibrate das28 pleiotropic effect Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/58336e98a8784ef2be4d26bf0920e649
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spelling	oai:doaj.org-article:58336e98a8784ef2be4d26bf0920e6492021-11-18T08:03:48ZPLEIOTROPIC EFFECTS OF SIMVASTATIN AND FENOFIBRATE IN PATIENTS WITH RHEUMATOID ARTHRITIS: A COMPARATIVE STUDY1563-06252313-741X10.15789/1563-0625-2019-1-121-128https://doaj.org/article/58336e98a8784ef2be4d26bf0920e6492019-01-01T00:00:00Zhttps://www.mimmun.ru/mimmun/article/view/1705https://doaj.org/toc/1563-0625https://doaj.org/toc/2313-741XWe 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.I. V. ShirinskyN. Yu. KalinovskayaV. S. ShirinskySPb RAACIarticlerheumatoid arthritissimvastatinfenofibratedas28pleiotropic effectImmunologic diseases. AllergyRC581-607RUMedicinskaâ Immunologiâ, Vol 21, Iss 1, Pp 121-128 (2019)
institution	DOAJ
collection	DOAJ
language	RU
topic	rheumatoid arthritis simvastatin fenofibrate das28 pleiotropic effect Immunologic diseases. Allergy RC581-607
spellingShingle	rheumatoid arthritis simvastatin fenofibrate das28 pleiotropic effect Immunologic diseases. Allergy RC581-607 I. V. Shirinsky N. Yu. Kalinovskaya V. S. Shirinsky PLEIOTROPIC EFFECTS OF SIMVASTATIN AND FENOFIBRATE IN PATIENTS WITH RHEUMATOID ARTHRITIS: A COMPARATIVE STUDY
description	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.
format	article
author	I. V. Shirinsky N. Yu. Kalinovskaya V. S. Shirinsky
author_facet	I. V. Shirinsky N. Yu. Kalinovskaya V. S. Shirinsky
author_sort	I. V. Shirinsky
title	PLEIOTROPIC EFFECTS OF SIMVASTATIN AND FENOFIBRATE IN PATIENTS WITH RHEUMATOID ARTHRITIS: A COMPARATIVE STUDY
title_short	PLEIOTROPIC EFFECTS OF SIMVASTATIN AND FENOFIBRATE IN PATIENTS WITH RHEUMATOID ARTHRITIS: A COMPARATIVE STUDY
title_full	PLEIOTROPIC EFFECTS OF SIMVASTATIN AND FENOFIBRATE IN PATIENTS WITH RHEUMATOID ARTHRITIS: A COMPARATIVE STUDY
title_fullStr	PLEIOTROPIC EFFECTS OF SIMVASTATIN AND FENOFIBRATE IN PATIENTS WITH RHEUMATOID ARTHRITIS: A COMPARATIVE STUDY
title_full_unstemmed	PLEIOTROPIC EFFECTS OF SIMVASTATIN AND FENOFIBRATE IN PATIENTS WITH RHEUMATOID ARTHRITIS: A COMPARATIVE STUDY
title_sort	pleiotropic effects of simvastatin and fenofibrate in patients with rheumatoid arthritis: a comparative study
publisher	SPb RAACI
publishDate	2019
url	https://doaj.org/article/58336e98a8784ef2be4d26bf0920e649
work_keys_str_mv	AT ivshirinsky pleiotropiceffectsofsimvastatinandfenofibrateinpatientswithrheumatoidarthritisacomparativestudy AT nyukalinovskaya pleiotropiceffectsofsimvastatinandfenofibrateinpatientswithrheumatoidarthritisacomparativestudy AT vsshirinsky pleiotropiceffectsofsimvastatinandfenofibrateinpatientswithrheumatoidarthritisacomparativestudy
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PLEIOTROPIC EFFECTS OF SIMVASTATIN AND FENOFIBRATE IN PATIENTS WITH RHEUMATOID ARTHRITIS: A COMPARATIVE STUDY

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