Effect of pravastatine plus ezetimibe on carotid intima media thickness in patients with lupus erythematosus
Main Article Content
Keywords
Atherosclerosis, Systemic lupus erythematosus, Intima media thickness, Pravastatin, Ezetimibe
Abstract
Background: Patients with systemic lupus erythematosus (SLE) have accelerated atherosclerosis that can be assessed by the carotid intima media thickness (CIMT) measurement. A prompt hypolipidemic treatment should be a part of the integral management. The aim of this study is to determine the effect of therapy with pravastatin plus ezetimibe on the CIMT in SLE patients.
Methods: Longitudinal, prospective, quasi-experimental trial. Out of 60 SLE patients in whom a carotid ultrasound was performed, we chose 22 with a CIMT > 0.7 mm who were administered pravastatin plus ezetimibe during 6 months with determination of CIMT at the end of the study. We performed the following tests: total cholesterol (TC), HDL-cholesterol, LDL-cholesterol, tryglicerides, C-reactive protein (CRP), liver function, muscle enzimes and glucose, basal and at the end of treatment. Statistical analysis: descriptive statistics and Wilcoxon test were used.
Results: There were 22 women with an age of 42 ± 6.3 years, average disease evolution 7.5 ± 6.6 years, of whom, 18 concluded the study. Right basal CIMT was 0.829 ± 0.1448 vs. final 0.688 ± 0.1453, p < 0.003; left CIMT was 0.820 ± 0.1312 vs. 0.724 ± 0.1348, p < 0.004. TC 208 mg/dl vs 168 mg/dl, LDL-C 125 mg/dl vs. 72 mg/dl, p = 0.0004. CRP 3.12 vs. 2.25 p = 0.004. In 2 cases there were gastrointestinal, skin and muscle adverse effects.
Conclusions: Treatment with pravastatin plus ezetimibe decreases the CIMT with improvement in the concentration of total cholesterol, LDL-C and CRP levels with good toleration.
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