Lupus Atherosclerosis Prevention Study (LAPS)
- PMID: 21177297
- DOI: 10.1136/ard.2010.136762
Lupus Atherosclerosis Prevention Study (LAPS)
Abstract
Background: Cardiovascular disease is one of the major causes of death in systemic lupus erythematosus (SLE). A study was undertaken to investigate whether treatment with statins would reduce subclinical measures of atherosclerosis over a 2-year period.
Methods: 200 patients with SLE without clinical cardiovascular disease were randomised to receive atorvastatin 40 mg daily or an identical placebo. At baseline and after 2 years of follow-up, helical CT scanning (for coronary artery calcium) and carotid duplex (for intima media thickness/plaque) were performed. Patients were seen for measures of disease activity at 1 month, 3 months and quarterly thereafter. The primary outcome variable was change in coronary artery calcium.
Results: At baseline, 43% had coronary artery calcium. At 2 years there was no significant difference between the groups in progression of coronary artery calcium, carotid intima media thickness or carotid plaque. There was no significant difference between the groups in disease activity, measures of inflammation or endothelial cell activation.
Conclusion: This study provides no evidence that atorvastatin reduces subclinical measures of atherosclerosis or disease activity over 2 years in patients with SLE. In fact, it does not appear to reduce biochemical measures of inflammation. The anti-inflammatory effects of statins observed in the general population were not replicated in this SLE clinical trial. Clinicaltrials.gov (NCT 00120887).
Trial registration: ClinicalTrials.gov NCT00120887.
Similar articles
-
Influence of atorvastatin on coronary calcifications and myocardial perfusion defects in systemic lupus erythematosus patients: a prospective, randomized, double-masked, placebo-controlled study.Arthritis Res Ther. 2011 Jul 20;13(4):R117. doi: 10.1186/ar3402. Arthritis Res Ther. 2011. PMID: 21774822 Free PMC article. Clinical Trial.
-
Secondary analysis of APPLE study suggests atorvastatin may reduce atherosclerosis progression in pubertal lupus patients with higher C reactive protein.Ann Rheum Dis. 2014 Mar;73(3):557-66. doi: 10.1136/annrheumdis-2012-202315. Epub 2013 Feb 22. Ann Rheum Dis. 2014. PMID: 23436914 Free PMC article. Clinical Trial.
-
Use of atorvastatin in systemic lupus erythematosus in children and adolescents.Arthritis Rheum. 2012 Jan;64(1):285-96. doi: 10.1002/art.30645. Arthritis Rheum. 2012. PMID: 22031171 Free PMC article. Clinical Trial.
-
Effect of intensive lipid lowering on progression of coronary atherosclerosis: evidence for an early benefit from the Reversal of Atherosclerosis with Aggressive Lipid Lowering (REVERSAL) trial.Am J Cardiol. 2005 Sep 5;96(5A):61F-68F. doi: 10.1016/j.amjcard.2005.07.013. Am J Cardiol. 2005. PMID: 16126025 Review.
-
[Dyslipidemia, atherosclerosis, and vulnerable plaques: the effect of atorvastatin on atherosclerosis and plaque structure].Turk Kardiyol Dern Ars. 2009 Mar;37 Suppl 2:11-6. Turk Kardiyol Dern Ars. 2009. PMID: 19404045 Review. Turkish.
Cited by
-
Mechanisms of premature atherosclerosis in rheumatoid arthritis and lupus.Annu Rev Med. 2013;64:249-63. doi: 10.1146/annurev-med-060911-090007. Epub 2012 Sep 27. Annu Rev Med. 2013. PMID: 23020882 Free PMC article. Review.
-
Expanding the therapeutic frontier in atherosclerosis.J Cardiovasc Pharmacol. 2013 Sep;62(3):237-8. doi: 10.1097/FJC.0b013e3182a18bea. J Cardiovasc Pharmacol. 2013. PMID: 23945275 Free PMC article. No abstract available.
-
A panel of biomarkers is associated with increased risk of the presence and progression of atherosclerosis in women with systemic lupus erythematosus.Arthritis Rheumatol. 2014 Jan;66(1):130-9. doi: 10.1002/art.38204. Arthritis Rheumatol. 2014. PMID: 24449580 Free PMC article.
-
The pleiotropic effects of the hydroxy-methyl-glutaryl-CoA reductase inhibitors in rheumatologic disorders: a comprehensive review.Rheumatol Int. 2012 Feb;32(2):287-94. doi: 10.1007/s00296-011-2008-6. Epub 2011 Jul 31. Rheumatol Int. 2012. PMID: 21805349 Review.
-
Apolipoprotein-containing lipoprotein subclasses and subclinical atherosclerosis in systemic lupus erythematosus.Arthritis Care Res (Hoboken). 2015 Mar;67(3):442-6. doi: 10.1002/acr.22430. Arthritis Care Res (Hoboken). 2015. PMID: 25155365 Free PMC article.
Publication types
MeSH terms
Substances
Associated data
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
