Ezetimibe and Simvastatin Reduce Inflammation, Disease Activity, and Aortic Stiffness and Improve Endothelial Function in Rheumatoid Arthritis
Kaisa M. Mäki-Petäjä, BSc*,1,*,
Anthony D. Booth, MD, MRCP2,*,
Frances C. Hall, DPhil, FRCP ,3,
Sharon M.L. Wallace, BA, RN*,
John Brown, DM, FRCP ,
Carmel M. McEniery, PhD* and
Ian B. Wilkinson, DM, FRCP2,*
* Clinical Pharmacology Unit, University of Cambridge, Cambridge, United Kingdom
Department of Clinical Medicine, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
Trinity College, University of Cambridge, Cambridge, United Kingdom.
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Figure 1 The Study Design
Following 2-week placebo run-in, patients received simvastatin or ezetimibe in a randomized double-blinded manner, each for 6 weeks, with a 6-week washout between the drugs.
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Figure 2 Effect of 10 mg Ezetimibe and 20 mg Simvastatin on Aortic PWV
Measurements were taken after 6 weeks of each treatment. Bars show mean and standard error of mean (n = 20). The omnibus significance for the trend was p = 0.001. The significance was determined by 2-way repeated measures analysis of variance with post hoc testing with Bonferroni adjustment. PWV = pulse wave velocity.
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Figure 3 Effect of 10 mg Ezetimibe and 20 mg Simvastatin on FMD
Measurements were taken after 6 weeks of each treatment. Bars show mean and standard error of mean (n = 20). The omnibus significance for the trend was p < 0.001. The significance was determined by 2-way repeated measures analysis of variance with post hoc testing with Bonferroni adjustment. FMD = flow-mediated dilation.
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Figure 4 Relationship Between Baseline ESR and Change in Aortic PWV Following Ezetimibe and Simvastatin
The change in aortic pulse wave velocity (PWV) following drug treatment was significantly associated with the baseline erythrocyte sedimentation rate (ESR); r = –0.416; p = 0.008. Solid circles = ezetimibe; open circles = simvastatin.
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