By [http://ezinearticles com/?expert=Dr. Nelson_Hargove] Dr. Nelson Hargove Rheumatoid arthritis is an inflammatory arthritis occurring in people who suffer from recurrent bouts of joint hurt swelling and deformity. Apart from inflammation of the joints there are abnormal changes in blood vessels in these people which puts them at an increased risk of cardiovascular diseases such as heart contend prematurely and reduction in life-expectancy. Excess number of deaths due to cardiovascular cause were consistently observed in people suffering from rheumatoid arthritis. A drug that controls the inflammation and also prevents changes in blood vessels ordain be highly useful in these populate. Statins (e g lovastatin simvastatin) have shown lot of promise in this regard. Statins inhibit an enzyme of the lipid metabolism called as HMG-CoA reductase; therefore they are called as HMG-CoA reductase inhibitors. affect of atherosclerosis i e clogging of blood vessels with cholesterol is accelerated in inflammatory arthritis. The levels of good (high density lipoprotein) cholesterol are abnormally low while those of bad (low density lipoprotein) cholesterol are higher in inflammatory arthritis. Statins reduce the low density lipoprotein cholesterol levels and check atherosclerosis. As atherosclerosis is the culprit for vascular events like heart contend and stroke the risk of these diseases is also reduced. Apart from lowering lipid levels the statins were open to have anti-inflammatory action in recent studies. In inflammatory arthritis statins may suppress the inflammatory response of the synovial membrane which lines the joint cavity. Statins act on blood cells like lymphocytes and macrophages which are responsible for inflammation and inhibit the channel of harmful chemicals like cytokines from these cells. As inflammation is responsible for clinical features of inflammatory arthritis statins markedly improve the clinical conceive of in these patients. Statins not only relieve pain and stiffness but also decelerate the ongoing process of joint destruction. Leung et al open that atorvastatin suppressed immune responses and cytokine release in mice. Abud-Mendoza C et al open that simvastatin showed marked improvement in signs and symptoms in patients with refractory rheumatoid arthritis which was unresponsive to methotrexate a powerful drug. Similarly atorvastatin was shown to be highly effective in rheumatoid arthritis in a recent randomized controlledtrial. Inflammation in rheumatoid arthritis is not confined to the joints only. Low-grade inflammation exists in blood vessels also. This along with break of endothelial cells lining daub vessels may accelerate the atherosclerotic process leading to vascular events such as heart attack at younger age as compared with normal population. Statins suppress this inflammation and check release of harmful free radicals. Statins also improve the function of endothelial cells. Statins also decrease the levels of C-reactive protein an independent assay factor for heart disease. Thus statins act as protectors against vascular events and may reduce the morbidity due to these diseases. Statins should be used in rheumatoid arthritis unresponsive to treatment with disease modifying anti-Rheumatic drug (DMARD) as adjuvant therapy. They can also be used in protection against vascular diseases. The existing statins are mainly developed to act as lipid modulating agents rather than anti-inflammatory drugs. advance investigate is required for developing new statins who undergo more potent anti-inflammatory action. Recently a new statin. Geranylgeranyl pyrophosphate (GGPP) has been open to undergo potent anti-inflammatory effects. advance trials are required to be its efficacy and safety. Thus statins ordain compete increasingly important role in management of inflammatory arthritis due to their multiple benefits. They improve the quality of life by relieving the symptoms of arthritis and at the same measure protect a person from premature death due to cardiovascular causes. References:1. McInnes IB. McCarey DW. Sattar N (2004) Do statins furnish therapeutic potential in inflammatory arthritis? Annals of the Rheumatic Diseases 63. 1535-37.:2. Leung BP. Sattar N. Crilly A. Prach M. Mccarey DW. Payne H. Madhok R et al (2003)A Novel Anti-Inflammatory Role for Simvastatin in Inflammatory Arthritis. The journal of immunology 170. 1524-30.:3. Abud-Mendoza C de la Fuente H. Cuevas Orta E et al (2003) Therapy with statins in patients with refractory rheumatic diseases: a preliminary study. Lupus 12. 607611.:4. McCarrey DW. McInnes IB. Madhok R et al (2004) Trial of atorvastatin in Rheumatoid Arthritis (TARA) double-blind randomized placebo-controlled trial. Lancet 363. 20152021.:5. Mason J C. Ahmed Z. Mankoff R. Lidington E A. Ahmad S. Bhatia V et al (2002) Statin-induced expression of decay-accelerating factor protects vascular endothelium against complement-mediated injury. Circulation investigate 91. 696703. About the Author: Dr. Nelson Hargove is a practising physician and seeks to provide the latest medical consensus from peer-reviewed medical literature. Article Source: [http://ezinearticles com/?expert=Dr. Nelson_Hargove ] http://EzineArticles com/?expert=Dr. Nelson_Hargove [http://ezinearticles com/?Statins:-A-New-Hope-in-Rheumatoid-Arthritis&id=156179 ] http://EzineArticles com/?Statins:-A-New-Hope-in-Rheumatoid-Arthritis&id=156179
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