Role of Atorvastatin as an add on therapy in standard treatment of Rheumatoid arthritis

AIMS AND OBJECTIVE :

Rheumatoid arthritis is the most common inflammatory arthritis affecting 1%of general population world wide. In India incidence is 0.75%. Some patients of RA do not respond well to standard treatment of rheumatoid arthritis. Knowing the fact that Atorvastatin has an anti-inflammatory effect other than cholesterol lowering effect. So we have added Atorvastatin as an add on therapy in standard treatment of RA.

MATERIAL AND METHOD :

We have included 60 patients attending medicine OPD with active RA. Patients divided in two groups. GROUP A-30 patients on standard regimen of RA. GROUP B- 30 Patients were given standard treatment plus Atorvastatin 20 mg/day HS. Patients were assessed 1st follow up at the end of 3 month and 2nd follow up at the end of 6 month. Assessment of Efficacy:This was done by 1. DAS28 Score 2. Visual analogue scale of 100mm. 3. C-Reactive protein. 4. ESR.

INCLUSION CRITERIA :

1. Age18-60years of both gender. 2- Active RA in spite of taking standard regimen for > 6months. 3- Rheumatoid factor positive. 4-C-Reactive positive > 6mg/lt 5- Disease activity score(DAS28) > 6.

EXCLUSION CRITERIA :

1-Age < 18years 2-Current treatment with lipid lowering drugs. 3-Contraindication to Statins.

RESULT :

Out of 60 patients who were enrolled in study, patients were followed up over 6 months DAS28 improved significantly on Atorvastatin(Group B)31% compared with GroupA10% without Atorvastatin. Compared to Group A reduction in CRP and ESR were 50% and 28% respectively in group. Swollen joint count were reduced and adverse effect occurred with similar frequency in both groups.

CONCLUSION :

These data shows that Statins can mediate modest but clinically apparent anti inflammatory effect with modification of vascular risk factor in context to high grade autoimmune inflammation.