Statins Do Not Influence Long-Term Rituximab Clinical Efficiency in Rheumatoid Arthritis Patients

OBJECTIVE This longitudinal study aims to determine if statins inhibit the response to rituximab in rheumatoid arthritis (RA) patients. METHODS 41 patients initiating rituximab were included; 17 patients were exposed to the combination of statins and rituximab. The total cholesterol, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were assessed. The clinical response was evaluated using Disease Activity Score (DAS28) and European League against Rheumatism (EULAR) response at 6 and 18 months. RESULTS A tendency of increasing in DAS28 was observed in statin-exposed group but the correlation was very weak (at 18 months: r = 0.013, P = 0.952). The statin-exposed status was negatively and very weakly correlated with EULAR response at 6 months (r = -0.073, P = 0.661) and 18 months (r = -0.197, P = 0.244). There was a negative correlation between statin-exposed status and inflammatory markers values (ESR and CRP); however, the correlation was very weak. The use of statin did not influence the cardiovascular risk measured by modified Systematic Coronary Risk Evaluation (mSCORE). CONCLUSIONS Long-term significant inhibitory effects of statins on rituximab treatment in RA have not been proved using clinical response scores or biologic markers.