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An open-label, randomized, crossover study to assess anti-inflammatory effect of Simvastatin in Rheumatoid Arthritis statin-naïve patients with associated risk factors for cardiovascular disease

Dissertation (MSc)--University of Pretoria, 2013.

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Other Authors: Greeff, O.B.W. (Oppel Bernhardt Wilhelm), 1948-
Format: Thesis
Language:English
Published: University of Pretoria 2014
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author2 Greeff, O.B.W. (Oppel Bernhardt Wilhelm), 1948-
author_browse Greeff, O.B.W. (Oppel Bernhardt Wilhelm), 1948-
author_facet Greeff, O.B.W. (Oppel Bernhardt Wilhelm), 1948-
collection Thesis
dc_rights_str_mv © 2013 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria.
description Dissertation (MSc)--University of Pretoria, 2013.
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institution University of Pretoria (South Africa)
language English
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provenance_str_mv Harvested via OAI-PMH from UPSpace — University of Pretoria Institutional Repository
publishDate 2014
publishDateRange 2014
publishDateSort 2014
publisher University of Pretoria
publisherStr University of Pretoria
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source_str UPSpace — University of Pretoria Institutional Repository
spelling oai:repository.up.ac.za:2263/40713 An open-label, randomized, crossover study to assess anti-inflammatory effect of Simvastatin in Rheumatoid Arthritis statin-naïve patients with associated risk factors for cardiovascular disease Greeff, O.B.W. (Oppel Bernhardt Wilhelm), 1948- aykoma@yahoo.co.uk Ally, Mahmood Moosa Tar Mahomed Komolafe, Ayoola Oluwakayode Cardiovascular disease Rheumatoid arthritis (RA) Anti-inflammatory effect Statin-naïve patients UCTD Dissertation (MSc)--University of Pretoria, 2013. Rheumatoid arthritis (RA) is a chronic inflammatory condition of unknown etiology for which there is no cure. It is one of the most disabling diseases and affects about 1% of the world‟s population. Recent developments in the field of molecular biology have resulted in the production of new drugs used in the treatment RA. Despite these advancements, achieving optimal disease control and prevention of disease progression is still difficult in many patients, leading to a continued search for treatment methods that will improve patient outcomes. Non-biologic forms of treatment that are still being investigated include the use of statins as an adjunct therapy due to their reported antiinflammatory effects. Some studies have shown that the use of statins in patients with RA help in reducing disease activity and swollen joint count in addition to lowering cardiovascular risk. As evidence continue to increase on the anti-inflammatory effect of statins, researchers have started investigating possible benefits that may result from the use of statins in treatment of RA, a chronic disease marked by high levels of systemic and local inflammation. This study investigated the anti-inflammatory effect of statins in rheumatoid arthritis patients with associated risks for cardiovascular disease, using simvastatin as the investigational product. Patients with moderately active RA despite being on maximum disease-modifying antirheumatic drugs (DMARDs) therapy and having associated risks for cardiovascular disease were screened for the study. Eligible patients were randomized into two groups, 1 and 2. Patients in group 1 received simvastatin treatment (20mg/day) for a period of 3 months in addition to their usual DMARDs after which they stopped simvastatin treatment and were followed up for a further 3 months off simvastatin treatment. Those in group 2 were allowed to continue on their usual DMARDs without simvastatin treatment for the first 3 months of the study after which they received 20mg/day simvastatin for a period of 3 months in addition to their usual DMARDs. The anti-inflammatory effect of simvastatin was assessed by monitoring the inflammatory variables; erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP) and disease activity in the two groups at screening, at the crossover point and at end of the study. Disease activity was significantly reduced with simvastatin treatment in the two groups. The mean change in disease activity score with simvastatin treatment was 1.30 (p = 0.01) in group 1 and 1.74 (p = 0.01) in group 2. ESR was significantly reduced with simvastatin treatment in group 1 with a mean change of 19.0 (p = 0.005) and marginally reduced in group 2 with a mean change 26.0 (p = 0.09). There was no significant change in CRP with simvastatin treatment in the two groups. The mean change in CRP with simvastatin treatment was 7.0 (p = 0.24) in group 1 and 14.7 (p =0.20) in group 2. All the patients benefited from the lipid-lowering effect of simvastatin. These findings suggest that statins may have mild anti-inflammatory properties and will be good adjuvant in RA patients with associated risks for cardiovascular disease. gm2014 Pharmacology unrestricted 2014-07-11T06:23:01Z 2014-07-11T06:23:01Z 2014-04-11 2013 Dissertation Komolafe, AD 2013, An open-label, randomized, crossover study to assess anti-inflammatory effect of Simvastatin in Rheumatoid Arthritis statin-naïve patients with associated risk factors for cardiovascular disease, MSc dissertation, University of Pretoria, Pretoria, viewed yymmdd <http://hdl.handle.net/2263/40713> E14/4/266/gm http://hdl.handle.net/2263/40713 en © 2013 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. application/pdf University of Pretoria
spellingShingle Cardiovascular disease
Rheumatoid arthritis (RA)
Anti-inflammatory effect
Statin-naïve patients
UCTD
An open-label, randomized, crossover study to assess anti-inflammatory effect of Simvastatin in Rheumatoid Arthritis statin-naïve patients with associated risk factors for cardiovascular disease
title An open-label, randomized, crossover study to assess anti-inflammatory effect of Simvastatin in Rheumatoid Arthritis statin-naïve patients with associated risk factors for cardiovascular disease
title_full An open-label, randomized, crossover study to assess anti-inflammatory effect of Simvastatin in Rheumatoid Arthritis statin-naïve patients with associated risk factors for cardiovascular disease
title_fullStr An open-label, randomized, crossover study to assess anti-inflammatory effect of Simvastatin in Rheumatoid Arthritis statin-naïve patients with associated risk factors for cardiovascular disease
title_full_unstemmed An open-label, randomized, crossover study to assess anti-inflammatory effect of Simvastatin in Rheumatoid Arthritis statin-naïve patients with associated risk factors for cardiovascular disease
title_short An open-label, randomized, crossover study to assess anti-inflammatory effect of Simvastatin in Rheumatoid Arthritis statin-naïve patients with associated risk factors for cardiovascular disease
title_sort open label randomized crossover study to assess anti inflammatory effect of simvastatin in rheumatoid arthritis statin naive patients with associated risk factors for cardiovascular disease
topic Cardiovascular disease
Rheumatoid arthritis (RA)
Anti-inflammatory effect
Statin-naïve patients
UCTD
url http://hdl.handle.net/2263/40713