Lupus Loophole Turns Out to be Dead-End

Statins not advised for routine use in pediatric lupus patients

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Even though pediatric lupus patients are at increased risk of developing heart disease as adults, statin drugs, which lower cholesterol, do not provide enough benefit to warrant use in these patients.

Children with lupus, an autoimmune disease that causes widespread inflammation and organ damage, often exhibit early signs of atherosclerosis (hardening of the arteries) putting them at risk of heart attack and stroke.

Researchers at Duke University Medical Center wanted to find a way to lower this risk and turned to statin drugs for the study. The randomized trial included 221 participants with pediatric lupus (ages 10 to 21). One group of patients were assigned statin drugs while the other group of children took placebo for 36 months.

While the statins appeared safe and effective in lowering blood-fat (lipid) levels and levels of an inflammation marker known as C-reactive protein (CRP), "their effect on atherosclerosis was not significant enough to warrant routine use," said Laura Schanberg, MD, a professor of pediatrics at Duke University Medical Center.

Close to 200,000 people in the U.S. have Lupus, with women being affected nine times more than men. Women of Afro/Caribbean descent are affected three times more often than other ethnic groups. Lupus is an autoimmune disease that attacks multiple organ systems and connective tissues in the body, is incurable, but treatable, and most people with it will live a normal lifespan. The initial symptoms of Lupus are fever, joint pain and fatigue. About 30 percent of lupus patients have dermatologic symptoms, with 30 percent to 50 percent getting the characteristic butterfly shaped rash on the face. Another very serious complication is end stage renal disease (ESRD), and kidney transplants are common. Lupus can also be drug induced by quinidine, phenytoin (Dilantin), hydralazine (Apresoline), and procainamide (Pronestyl), but is fortunately reversible. Drugs used to treat lupus are frequently DMARDS (disease modifying anti-rheumatic drugs) such as Humira, Rituxan, Remicade, Methotrexate, and Enbrel; Steroids and other immunosuppressants help reduce symptoms as well, with examples being Belimumab and Atacicept. Painkillers are common and often necessary. An ANA (anti-nuclear antibody) blood test is frequently used to diagnosis lupus.

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Review Date: 
January 26, 2011
Last Updated:
March 10, 2011