Yarosh V. Clinical course and inflammatory markers in patients with Rheumatoid arthritis under the influence of statin therapy

The aim of the study was to improve the effectiveness of therapy of RA through the use of statins in addition to standard therapy by studying the dynamics of clinical indicators of inflammatory process - the number of painful and swollen joints, duration of morning stiffness, visual analog scale, ESR, spectrum of serum lipides, proinflammatory citokine tumor necrosis factor alpha (TNF-alfa), anti-inflammatory cytokine interleykin-4 (IL-4), acute phase protein as sensitive C-reactive protein (CRP), a marker of disese prognosis and degree of destructive changes - citrullin vimentin (CV) under the influence of statins treatment. It is found that the use of statins in addition to standard therapy in patients with rheumatoid arthritis improves the clinical course of disease and is reasonable regardless of the patient's lipids profile. The favorable effect of statins is provided by their antiinflammatory and immunomodulatory properties, which is confirmed not only by changes in clinical indicators of process activity, but also in the changes of cytokine profile. The mechanism of statins' action is different: simvastatine affects mainly the antiinfammatory cytokine IL-4, and atorvastatine predominately on CRP. Statins reduce the level of diagnostic and prognostic marker citrullin vimentin. Significant reduction of CV in combination with higher levels of IL-4 when receiving simvastatin, and established relation of their changes to dynamics of clinical data suggests the pathogenetic role of CV in the RA and the anti-inflammatory effect of simvastatin, manifesting in dose-independent reduction of destructive changes in joints. Key words: rheumatoid arthritis, statins, clinical indicators of activity, tumor necrosis factor-alfa, interleukin-4, citrullin vimentin.