Statin therapy for targeting cardiovascular risk in rheumatoid arthritis

Abstract

Rheumatoid arthritis (RA), a prototypical immune-mediated inflammatory disease, is now definitely recognized to increase cardiovascular morbidity and mortality, irrespective of established classical risk factors. The chronic inflammatory state, a hallmark of RA, is increasingly considered to be a driving force for accelerated atherogenesis. Consequently, aggressive control of RA disease activity has been suggested to be instrumental for cardiovascular risk reduction. Currently, statins are the cornerstone of cardiovascular risk-reducing strategies. Apart from their lipid-lowering capacity, statins also exert immune-modulatory effects, which therefore may be of dual benefit in RA patients. Yet guidelines for optimal cardiovascular risk reduction in patients with RA are lacking, largely owing to the absence of randomized, clinical trial data. In this review, we focus on the pathophysiology and observational evidence of cardiovascular risk in RA, as well as the need to adjust currently employed cardiovascula...