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Revista Colombiana de Reumatología
Print version ISSN 0121-8123
Abstract
MUNOZ, Óscar Mauricio et al. Therapeutic impact of statins on the lipid profile and cardiovascular risk of patients with rheumatoid arthritis: Systematic literature review and meta-analysis. Rev.Colomb.Reumatol. [online]. 2019, vol.26, n.1, pp.40-47. ISSN 0121-8123.
Context:
Patients with rheumatoid arthritis have a higher cardiovascular risk due to the prevalence of cardiovascular risk factors and metabolic alterations derived from the inflammatory activity and the treatment of their disease. A systematic evaluation of the effect of statins on lipid fractions and cardiovascular outcomes has not been carried out specifically in patients with rheumatoid arthritis.
Methods:
A literature search was conducted in Medline (PubMed), Embase, Lilacs, SciELO, and Cochrane. Randomized and non-randomized clinical trials were selected that evaluated the impact of statins on mortality, cardiovascular events, lipid fractions and disease activity in patients with rheumatoid arthritis. A paired evaluation of risk of bias was carried out, along with a meta-analysis using RevMan 5.3®.
Results:
A total of 5 studies and 383 patients were included in the analysis. The use of statins among patients with rheumatoid arthritis significantly reduced total cholesterol levels: -46.16mg/dL (95% CI: [-53.89, -38.46]; I 2: 86%), LDLc: -18.13mg/dL (95% CI: [-21.8, -14.4], I 2: 97%) and TG of -34.95 mg/dL (95% CI: [-44.3, -25.6], I 2: 0%), without significant changes in HDLc. It also reduced the activity of the disease (DAS28) by 0.73 (95% CI: [-0.94, -0.53], I 2: 96%). No study was found that reported mortality or cardiovascular outcomes.
Conclusion:
The lipid-lowering effect of statins in patients with rheumatoid arthritis is consistent with that found in other populations. There is a slight impact in reducing the activity of the disease, but reducing the risk of cardiovascular events in this specific population has not been studied.
Keywords : Statins; Rheumatoid arthritis; Cardiovascular risk; Lipids.