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Endothelial function may improve in patients with inflammatory joint diseases treated with Crestor
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Patients with inflammatory joint diseases, including rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis, who had carotid plaque verified by ultrasound and received Crestor had improved endothelial function, according to recently published data.
Researchers studied 53 patients with rheumatoid arthritis, 24 patients with ankylosing spondylitis and eight patients with psoriatic arthritis who received Crestor (rosuvastatin, AstraZeneca) at 20 mg at baseline (5 mg in patients over 70 years) and up to 40 mg until the target of up to 1.8 mmol/L of LDL was met for up to 18 months. Patient characteristics between groups were similar with the exception of sex and prescribed medications related to the present disease.
Flow-mediated vasodilation (FMD) was measured at baseline before initiation of rosuvastatin as a measure of endothelial function. Recordings were made with fasting patients abstinent from smoking or medication using a Vivid 7 scanner (GE Vingmed Ultrasound) with a 10 MHz transducer. The percent change between the baseline diameter and the largest diameter of the brachial artery during the first 2 minutes of 5-minute forearm occlusion was measured by an examiner blinded to patient details. All recordings were performed by a single examiner at baseline and at 18 months. Arterial stiffness was measured using Sphygmocor apparatus to measure augmentation index and aortic pulse wave velocity.
An improvement of 1.6% was seen in FMD on average at 18 months and the area under the curve was increased by 27.7% for the mean brachial artery diameter from 0 to 120 seconds at 18 months compared to baseline. No significant predictors of the change in FMD were observed in adjusted and unadjusted analyses. Linear regression showed that changes in carotid plaque and augmentation index were negatively associated with changes to FMD. No correlations were observed with inflammatory markers, disease activity, lipid profile, carotid intima media thickness or rosuvastatin dose.
– by Shirley Pulawski
Disclosure: The study drug was provided by AstraZeneca. Ikdahl reports receiving speaker honoraria from Pfizer. Please see the full study for a list of all other authors’ relevant financial disclosures.
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