March 17, 2006 - A study published in the Journal of the American Medical Association has, for the first time, shown that high doses of a cholesterol-lowering “statin” drug can clear the kind of sticky plaque and fatty deposits in arteries that cause most heart attacks.

While there is no indication that any of the more than 500 individuals involved in the trial had systemic lupus erythematosus, the findings are notable for people with this chronic autoimmune disease because so many have clogged arteries.

Already, many Americans—including individuals with lupus—take “statin” drugs to prevent or slow coronary artery disease, a condition long viewed as relentlessly progressive.

“The current study suggests that there is potential for a more optimistic strategy,” the JAMA study authors write, “in which aggressive lipid-modulating strategies can actually reverse the atherosclerotic disease process.” If true, the statins may offer a nonsurgical way to treat heart disease.

“This is an exciting observation because it indicates true potential for high doses of statins to actually decrease atherosclerotic areas in blood vessels, which should of course lower the chances that a person will develop heart attack,” said Bevra Hahn, M.D., Chief of Rheumatology at the School of Medicine at the University of California in Los Angeles.

“With regards to use in patients with systemic lupus erythematosus (SLE), we must remember that early data released in abstract from the NIH-sponsored study of statins in people with SLE showed that the side effects of statins were considerably more common in SLE patients than they are in the population at large,” she said. Initial findings from the two-year study of atorvastatin (Lipitor) versus placebo for preventing lupus atherosclerosis, published in the September 2005 abstract issue of Arthritis and Rheumatism, point to more toxicity (liver and muscle damage) from statins in people with lupus than in the general population.

Dr. Hahn adds: “It may be that a good strategy will be to identify SLE patients at particularly high risk for atherosclerotic heart attack and then use this new therapy. In the meantime, we eagerly await the results of the statin trial in SLE.”

Robert Eisenberg, M.D., Professor in the Division of Rheumatology at the University of Pennsylvania School of Medicine, said that “based on the preliminary information I have seen on this study, it appears that, if high doses of statins lead to a more effective way to prevent the cardiovascular consequences of atherosclerosis, either primarily or secondarily—such as in patients who have not or have, respectively, experienced clinical events—then clearly such an approach might well be applicable to the SLE population by helping to mitigate their greatly increased risk of atherosclerotic cardiovascular disease.”

He added: “It makes it all the more important to define and validate additional surrogate outcomes in the SLE population for atherosclerotic cardiovascular disease, so that novel therapeutic/preventative approaches, such as high-intensity statins, can be efficiently tested to see if they could help SLE patients.”

The anti-inflammatory properties of statins currently are being investigated for other aspects of lupus as well, such as kidney disease (nephritis) and overall inflammation.

This JAMA press release provides study details: