Statins May Be Protective Against Vascular Inflammation in Patients With PMR, GCA

Treatment with statins may play a role in preventing vascular inflammation in patients with polymyalgia rheumatica (PMR) and giant cell arteritis (GCA), according to study results published in Clinical and Experimental Rheumatology.

Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is often used to detect large-vessel vasculitis (LVV) among patients with PMR and GCA, as well as those with fever of unknown origin (FUO).

Researchers investigated whether the use of statins could reduce vascular inflammation among patients with PMR, GCA, and FUO, as evaluated by FDG-PET/CT.

Patient data from January 2009 to April 2016 were included in the analysis. Vascular uptake was assessed with a visual score and volumetric regions of interest (VOIs) on CT scans. FDG arterial uptake was calculated using mean standardized uptake values (SUVs) within VOIs. Arterial uptake was quantified on a 4-point scale, with the summation for each patient comprising their total vascular score (TVS).

A total of 129 patients (67.4% women) were included in the analysis; 96 patients were diagnosed with PMR, 16 with GCA, 13 with PMR-associated GCA, and 4 with FUO. The LVV was visualized in 58.1% of patients using PET/CT scan and was present in 50% of patients with PMR, 75% of those with GCA, 84% of those with both PMR and GCA, and 100% of patients with FUO. A total of 15.5% of patients used statins.

Median TVS was significantly lower among patients who used vs did not use statins (P =.02). When TVS was stratified according to specific arterial sites, total score was significantly lower at the aortic arch (P =.023), ascending aorta (P =.017), and both right (P =.023) and left (P =.027) femoral arteries among patients who received vs did not receive statins. Among patients who used statins, differences in arterial uptake were more pronounced in the aortas of patients with LVV (P =.07) and femoral arteries (P =.05) of patients without LVV.

When multiple regression analysis was performed to assess the effects of statin use on clinical and laboratory values, fever was present more often in patients who used vs did not use statins (P =.03).

This study was limited by its retrospective and observational design. In addition, it may have been possible that the use of statins was underreported by patients, accounting for a low value overall. Finally, the makeup of the study population was not well-balanced.

Researchers concluded, “The results of our clinical study indicate that statins may play some potential anti-inflammatory role and support the view that further studies should be performed to test this hypothesis. These observations are in line with the known pharmacological properties of statins, in particular with the literature data reporting their use in inflammatory conditions, such as atherosclerotic plaques and rheumatoid arthritis.”