Trial of Atorvastatin in Rheumatoid Arthritis (TARA): double-blind, randomised placebo-controlled trial

摘要: Summary Background Rheumatoid arthritis is characterised by inflammatory synovitis, articular destruction, and accelerated atherogenesis. HMG-CoA (3-hydroxy-3-methylglutarylcoenzyme A) reductase inhibitors (statins) mediate clinically significant vascular risk reduction in patients without disease might have immunomodulatory function. We postulated that statins reduce factors rheumatoid modify surrogates for risk. Methods 116 with were randomised a double-blind placebo-controlled trial to receive 40 mg atorvastatin or placebo as an adjunct existing disease-modifying antirheumatic drug therapy. Patients followed up over 6 months activity variables circulating measured. Coprimary outcomes change score (DAS28) proportion meeting EULAR (European League Against Rheumatism) response criteria. Analysis was intention treat. Findings At months, DAS28 improved significantly on (−0·5, 95% CI −0·75 −0·25) compared (0·03, −0·23 0·28; difference between groups −0·52, Cl −0·87 −0·17, p=0·004). achieved 18 of 58 (31%) allocated six (10%) (odds ratio 3–9, 1·42–10·72, p=0·006). C-reactive protein erythrocyte sedimentation rate declined 50% 28%, respectively, relative (p Interpretation These data show can modest but apparent anti-inflammatory effects modification the context high-grade autoimmune inflammation.