Therapeutic Impact of Statins on the Lipid Profile and Cardiovascular Risk in Patients With Systemic Lupus Erythematosus: Systematic Review of the Literature and a Meta-analysis

Background: There is strong evidence of a rise in cardiovascular risk in patients suffering from autoimmune diseases, especially in those with Sistemic Lupus Erythematosus. Until now, there are a few trials that assess the potencial benefit of statins on the incidence of cardiovascular events and on lipid profile of patients with SLE. This evidence has not been synthesized and assessed altogether. Methods: We performed a search in databases of literature published until August of 2016 (Embase, MEDLINE, Cochrane Library, SciELO, Clinical Evidence, DynaMed, Cochrane Central Register of Controlled Trials, LILACS), identifying controlled clinical trials that could estimate the impact of statins on mortality, cardiovascular events, C-reactive protein and lipid profile in patients with Systemic Lupus Erythematosus. The quality of the information available was assessed with a meta-analysis, using a random effects model, employing the RevMan 5.3 software. Results: 6 trials and 412 patients were included in the analysis. The use of statins in patients with SLE was found to significantly reduce the levels of serum total cholesterol (mean difference [MD] –31,4 mg/dL; CI 95% –43,0; –19,9), and serum low density cholesterol (MD –31,4 mg/dL; IC 95% –43,0; –19,9), but had no impact on levels of serum triglycerides (MD 4 mg/dL; IC 95% 2,49; 6,21) and C-reactive protein (MD –0,78; IC 95% –1,43; –0,13). No evidence was found about the impact on the risk of mortality or cardiovascular events. Conclusion: Statins have a significant effect on the levels of serum total cholesterol, LDL cholesterol and C-reactive protein, however, more randomized controlled trials with long-term follow-up are necessary to assess the impact on mortality and cardiovascular risk.