Cardiovascular disease is a major factor in the mortality gap between patients with and those without rheumatoid arthritis (RA). Despite this, no specific cardiovascular prevention guidelines have been created for patients with inflammatory joint disease. This study was designed to determine whether aggressive statin treatment affects cardiovascular risk factors in patients with inflammatory arthritis.

Subjects were patients with inflammatory arthritis who were statin naïve, and for whom carotid plaque had been identified. The participants were initiated on rosuvastatin, 20 mg per day, with increasing doses titrated to achieve an LDL cholesterol level of 1.6 to 1.8 mmol per liter. The patients were evaluated by a cardiologist at three months and 18 months, with blood drawn to assess lipid profiles, liver enzymes, creatine kinase, sedimentation rate and C-reactive protein. Carotid ultrasound was used to assess carotid plaque.

After 18 months of treatment, the mean change in carotid plaque height was 1.9 mm. (P<0.0001). No significant change was seen in intima media thickness. In 72% of the patients with multiple carotid plaques, a reduction in height was seen in more than half of the plaques. No changes in measures of RA disease activity were noted. Further, no significant relationship was found between the degree of carotid plaque height reduction and LDL measurements or changes in measurements. A logistic regression analysis revealed that the change in carotid plaque height was not related to changes in body mass index, smoking status or treatment with anti-rheumatic medication.

This uncontrolled study of patients with inflammatory arthritis found that intensive lipid lowering treatment with rosuvastatin induced atherosclerosis regression.