The effects of statins on osteoarthritis structural progression: another glimpse of the Holy Grail?

摘要: While the last 2 decades have seen major advances and novel treatments for inflammatory arthritides, osteoarthritis (OA) not advanced. Meanwhile, OA represents a huge problem both individuals health economies, with burden rising quickly in ageing Western societies. Recent evidence-based guidelines provide range of options pain relief,1 often associated small to moderate effect sizes.3 True structure modification, its implication an reduction (or at least reduced progression) symptoms, is referred as Holy Grail research.4 5 In context chasing this Grail, interesting report from Clockaerts colleagues6 adds growing strand research concerning potential role statins modifiers OA. A number questions arise result work: Is there plausible mechanism action context? real signal structural progression other clinical studies statins? Statins are best known competitive inhibitors hydroxymethyl-glutaryl-coenzyme reductase that reduce cholesterol biosynthesis. However, some years it has been recognised these agents also significant anti-inflammatory immune-modulating effects.7,–,9 So, possible may benefit joint through non-mutually exclusive mechanisms on different targets. Inflammation appears universal symptomatic joints, mediators produced by cartilage, bone synovial cells;10 11 inflammation thought be important subsequent cartilage degradation. multitude effects reported cellular level including inhibition leucocyte–endothelial adhesion, levels inducible nitric oxide synthase, production chemoattraction monocyte chemotactic protein-1, …