Statins Reduce Disease Activity (SLAM-R) and Organ Damage Accrual (SLICC Damage Index, SDI) Scores in SLE Patients From A Multi-Center, Multi-Ethnic, US Cohort.

Statins, in addition to lower cholesterol levels, have anti-thrombotic, anti-inflammatory and cardiovascular protective effects. Cardiovascular morbidity and accelerated atherosclerosis are important SLE features, but It is unclear whether statins have beneficial effects in these patients.

To assess longitudinally the impact of statins on levels of biomarkers (cytokines/chemokines), SLAM-R and SDI.

Sera from 21 SLE patients (ACR criteria) from a multi-ethnic, multi-center cohort were assessed at baseline and at a subsequent visit after statin treatment started. Patients on >10 mg prednisone/day, or on other immunosuppressant were excluded (age range: 16-67; mean age: 44.6 yrs); 38% African American, 9% Caucasians and 4% Puerto Rican Hispanics; 86% female. Serum levels of IL1b, IL6, IL8, IFN- α,, IP-10, MCP-1. VEGF, sCD40L and TNF- α, were measured using a Millipore Millliplex™ Multiplex Assay and titers of soluble (s) E-selectin (E-sel), intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), were detected by ELISA. High sensitive C reactive protein (hsCRP) was measured by nephelometry. Changes in the levels of biomarkers were tested using a signed rank test. Changes in levels of biomarkers and those in SLAM-R or SDI scores were examined with Spearman correlations.

SLAM-R and SDI scores were significantly decreased by statins (p=0.0199 and 0.039, respectively). IL1b, IL6, IL8, TNF-α, VEGF, IP-10, sCD40L and sVCAM-1 levels were reduced after treatment with statins in 28%, 28%, 52%. 43%, 57%, 42%, 52% and 62% of the subjects that had detectable levels of the biomarkers at baseline, respectively, but the overall reduction was not statistically significant (see Table). hsCRP was increased in 50% of the subjects at baseline (over the cut-off point) and reduced by 37% after treatment with statins. Importantly, the changes in IL-6 after treatment with statins correlated with changes in SLICC scores (p=0.036

Significant number of SLE patients' samples showed a decrease in levels of some cytokines and chemokines and of hsCRP after statin treatment. Importantly, SLAM-R and SDI scores were significantly reduced by statins and the changes in IL-6 correlated with a significant decrease in organ damage accrual (SLICC).

No relevant conflicts of interest to declare.