Statins have not proved to be beneficial enough to be used regularly on children and adolescents, states a study.
Lupus is an autoimmune disease that causes widespread inflammation and organ damage. Children with lupus show early signs of atherosclerosis-the fatty tissue buildup that is the precursor to clogged arteries.
AdvertisementStatins were the obvious choice for investigation since they have proven effective at decreasing heart disease incidence in many adult populations.
"We thought every child with lupus should routinely be put on statins," Laura Schanberg, a professor of pediatrics at Duke University Medical Center, said.
"This study proves that's not the case. The statins had positive effects on CRP and lipid levels, and they appear to be safe and well tolerated. But their effect on atherosclerosis was not significant enough to warrant routine use," said Schanberg,
It randomized 221 participants with pediatric lupus (ages 10 to 21) from 21 sites within the Childhood Arthritis and Rheumatology Research Alliance (CARRA) to two groups. One group received atorvastatin (Lipitor), the other received placebo for 36 months.
The researchers used ultrasound techniques to detect thickening of the arterial wall of carotid arteries. They also studied blood lipid levels, inflammation markers including C-reactive protein (CRP), and lupus disease activity measures.
"There are rare long-term risks associated with statins that outweigh the risks of using them routinely without proof of clinically significant benefit," Schanberg said.
Further analysis is needed to determine whether sub groups of the study participants might derive more benefit from statin therapy.
"We're not saying statins should never be used in kids with lupus," she said.
"Rather, we showed that statins should not be routinely prescribed to children with lupus. A lot more information has to go into the decision, and further investigation will help us arrive at a more definitive answer," she added.
The findings were presented at the American College of Rheumatology meeting in Atlanta.