Statin Therapy Does not Seem to Benefit Giant Cell Arteritis

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Objective

Since statins interfere with a variety of immune-inflammatory pathways shared by atherosclerosis and giant cell arteritis (GCA), they might be potentially useful as adjunctive therapy to glucocorticosteroids in GCA. Our aim was to examine whether concomitant use of statins had any potential benefit in GCA.

Methods

Retrospective follow-up study of an unselected population of 121 patients with GCA. A comparative analysis between patients with and without statin therapy was performed.

Results

At the time of the GCA diagnosis, 30 patients (25%) had already been receiving statins and continued taking them during the corticosteroid treatment. No statistically significant reduction in the incidence of severe ischemic complications (including visual manifestations, jaw claudication, cerebrovascular accidents, ischemic heart disease, and limb claudication due to large artery stenosis) was observed in this group compared with the remaining patients. When we analyzed follow-up data, we found no significant differences between groups in terms of frequency of relapses, incidence of aortitis, and percentage of patients recovered from GCA. The duration of therapy and corticosteroids requirements among patients in permanent remission was similar in both groups.

Conclusion

We did not observe a significant benefit derived from the use of statins at low to moderate doses in the incidence of severe ischemia or the disease outcome.

Section snippets

Patients and Methods

We conducted a retrospective follow-up study in 121 patients with GCA diagnosed by the Department of Rheumatology within the Hospital Universitario de Bellvitge (Barcelona, Spain) from January 1986 until December 2004. The diagnosis of GCA was made according to the 1990 ACR criteria for the classification of GCA (18), as follows: (1) age at disease onset ≥50 years; (2) new onset of headache; (3) temporal artery abnormality on examination (decreased pulses unrelated to arteriosclerosis, nodules,

Results

The series included 84 women and 37 men (ratio 2.2) with a mean age at time of diagnosis of 74 ± 7 years (range, 56 to 89). The mean duration of symptoms before the diagnosis was 3.2 months. TAB was positive in 88 (73%) patients. The main clinical features and laboratory data of the study cohort are summarized in Table 1. Information about the clinical characteristics of most of these patients has been extensively reported elsewhere (19, 20, 21, 22, 23, 24, 25).

At the time of the GCA diagnosis,

Discussion

Inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase or statins constitute the most powerful class of lipid lowering drugs, widely used in medical practice. During the past several years, additional actions of statins unrelated to cholesterol reduction have been identified that include antiinflammatory and immunomodulatory properties (12, 13, 14, 15, 16, 17). Statins effectively repress major histocompatibility complex class II antigen expression induced by IFN-γ in a variety of cells

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    Javier Narváez and Berta Bernad contributed equally to this work.

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