Statins – are they potentially useful in rheumatology?

For more than 30 years statins have been successfully used in patients with hypercholesterolemia and cardiovascular diseases. Recently, there is a growing body of evidence, that statins exert effects by much exceeding the effect of cholesterol level decrease. Inhibition of earlier stages of cholesterol biosynthesis pathway (not influencing the very cholesterol level) results in blocking the intermediate metabolite synthesis; isoprenoids (farnesyl phosphate and geranyl phosphate), which play a regulatory function in cells. Statins have antiatherosclerotic, antiinflammatory, antioxidant, immunomodulatory and antithrombotic effects. It applies equally to diseases of chronic inflammation type, as to those, where bone metabolism is disturbed. It is well known that statins decrease bone fracture risk; through bone formation intensification, and inhibition of bone tissue resorption. Slowing down the atherosclerosis progression is a very important effect, considering that in rheumatoid arthritis (RA) and in systemic lupus erythematosus (SLE) we are dealing with premature and rapid progression of atherosclerotic lesions. In this paper statins pathways of action in rheumatic diseases (including pleiotropic effects), and their potential use in rheumatology have been discussed. Though there is lack of reliable data enabling statins introduction to standard complementary therapy in rheumatic diseases, the results however of completed studies allow concluding of their utility. The statins that were most frequently evaluated in clinical studies were simvastatin and atorvastatin. Studies on statins have been performed in RA, SLE, osteoporosis and systemic vasculotos.