Introducción: Los pacientes con lupus eritematoso sistémico (LES) cursan con ateroesclerosis acelerada que puede ser evaluada mediante el grosor íntima-media carotídea (IMC). El uso de hipolipemiantes debe ser parte de su tratamiento. El objetivo de este estudio fue determinar el efecto de la terapia con pravastatina más ezetimibe en el grosor IMC en pacientes con LES.
Métodos: estudio prospectivo, longitudinal, cuasi-experimental. De 60 paciente con LES a quienes se le realizó ultrasonido carotídeo, de los cuales se eligieron a 22 con grosor IMC > 0.7 mm y se les administró pravastatina más ezetimibe durante seis meses y posteriormente se determinó el grosor IMC. Se les determinó colesterol total (CT), colesterol HDL (c-HDL), colesterol LDL (c-LDL), triglicéridos, proteína C-reactiva (PCR), pruebas de funcionamiento hepático, enzimas musculares y glucosa basales y posterior al tratamiento. Análisis estadístico: estadística descriptiva y prueba de Wilcoxon.
Resultados: se incluyeron 22 mujeres con edad 42 ± 6.3 años y evolución promedio 7.5± 6.6 años, de las cuales concluyeron el estudio 18 pacientes. El grosor IMC derecha basal fue de 0.829 ± 0.1448 frente a final 0.688 ± 0.1453, p < 0.003; el izquierdo 0.820±0.1312 frente a 0.724±0.1348, p < 0.004. El CT 208 mg/dl frente a 168 mg/dl, y el c-LDL 125 mg/dl frente a 72 mg/dl, p = 0.0004. Niveles de PCR 3.12 frente a 2.25 p = 0.004.
Conclusiones: el tratamiento con pravastatina más ezetimibe disminuye el grosor IMC con mejoría en las concentraciones de colesterol total, colesterol LDL y niveles de PCR, así como buena tolerancia.
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