Potential role of statins and PPARs in rheumatoid arthritis

Author: Douglas Karen MJ   Sattar Naveed   Kitas George D  

Publisher: Future Medicine

ISSN: 1746-0816

Source: Future Rheumatology, Vol.1, Iss.2, 2006-04, pp. : 259-274

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Abstract

Rheumatoid arthritis (RA) is a chronic disease characterized by joint inflammation and subsequent destruction. RA is associated with an increased risk of cardiovascular disease. There are many possible reasons for this, which include lipid abnormalities, inflammation and possibly insulin resistance, all of which are risk factors for atherosclerosis in the general population. During the last decade, the 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, or statins, have had a substantial impact on improving cardiovascular outcomes primarily via low-density lipoprotein-lowering, although pleiotropic anti-inflammatory and immunomodulatory properties may also be relevant. The peroxisome proliferator-activated receptor (PPAR) agonists, fibrates and thiazolidediones also affect lipid homeostasis, improve insulin resistance and may have anti-inflammatory effects by controlling cell proliferation, differentiation and apoptosis. In this review the authors discuss the potential applications of statins and PPAR agonists in RA, in the context of the modification of both cardiovascular risk and joint disease.