Statins could treat antiphospholipid syndrome, according to a new study
According to a study which will be presented at the annual meeting of the American College of Rheumatology / Association of Rheumatology Health Professionals (ACR / ARHP), statins could be new treatment for antiphospholipid syndrome.
Dr Doruk Erkan, MD, an associate attending rheumatologist and clinician researcher at Hospital for Special Surgery in New York City, who was one of the two main investigators in the study, said the study showed that in patients with antiphospholipid syndrome these inflammatory and thrombotic proteins are high and that statins may help lower them. However researchers said that these drugs can not be used during pregnancy because of fetal harm.
Statins are drugs that lower bad cholesterol that is LDL cholesterol. Their mechanism of action consists of HMG Co A reductase inhibition, an enzyme involved in producing cholesterol. Statins are highly effective in patients who have atherosclerosis, because it turned out that these drugs prevent plaque formation and causes regression of already formed plaques.
Antifosfopidic syndrome is an autoimmune disorder characterized by hypercoagulability, that is the increased tendency of blood to form clots. This syndrome occurs due to the formation of antibodies against phospholipids, which are part of the structure of cell membranes. Antiphospholipid syndrome may be part of the disease such as systemic lupus erythematosus, or can occur as primary disease. Treatment consists of administration of anticoagulants.
Increased tendency to form blood clots prevent women to have children because it leads to miscarriage or preterm delivery. Therefore, pregnant women with antiphospholipid syndrome should be treated with drugs that do not affect the fetus, such as heparin. It should be noted however that not all aPL-positive patients have blood clotting problems or complications of pregnancy.
Researchers at Hospital for Special Surgery and the University of Texas Medical Branch, Galveston, Texas, conducted a study that enrolled 41 patients aPL-positive, some of whom were healthy and some who had symptoms. Analysis of 12 proteins were compared with results from 30 patients aPL negative. Of the 12 inflammatory proteins, 9 were elevated in these patients.
Then the researchers wanted to know whether statins have a role in reducing inflammatory proteins. And indeed they were right because inflammatory protein level decreased due to statin use.
After 3 months of treatment, in which patients received fluvastatin 40 mg per day, the level of 8 of the 12 proteins decreased significantly. What the researchers also discovered was that after discontinued the treatment, the level of 6 proteins increased, a phenomenon known as rebound. Dr. Erkan said that this is the first prospective study that examines these inflammatory proteins in patients with antiphospholipid syndrome before and after treatment with fluvastatin. The next step is to create a randomized clinical trial to assess the effects of statins.