Rheumatoid arthritis patients now being recruited to take part in major statins trial
Rheumatoid arthritis (RA) sufferers attending a number of hospitals around the UK are being invited to take part in a major new trial to find out if taking statins reduces the number of patients dying of heart attacks and strokes.
RA patients have an increased risk of dying from cardio-vascular complications compared to the general population, but few are routinely prescribed the cholesterol-lowering drugs, statins.
The study, led by Professors George Kitas and Deborah Symmons at the University of Manchester, hopes to recruit a total of almost 4,000 people in a UK-wide five-year £1.1m multi-centre trial, funded jointly by the Arthritis Research Campaign and the British Heart Foundation.
Doctors running the trial said that if, as expected, statins were shown to be effective in reducing cardio-vascular deaths in rheumatoid arthritis, most patients with this condition should be put on the drugs as a matter of course.
Over the next two years more than 60 rheumatology departments around the UK will be involved in recruiting patients over the age of 50 who have not been judged eligible for statins as per NICE guidance. They will be given either a statin or a placebo, in addition to any other treatment they require for their arthritis, and will all receive advice on how to reduce the risk of heart disease by exercising, eating healthily and stopping smoking.
RA patients attending the following hospitals will invited to take part in the trial: Russells Hall Hospital, Dudley; Walsgrave Hospital, Coventry; Derby Royal Infirmary, Derby; the Royal Glamorgan Hospital, Llantrisant; Cannock Chase Hospital, Cannock; Southmead Hospital, Bristol; Macclesfield General Hospital, Macclesfield; Arrowepark Hospital, Wirral; Haywood Hospital, Stoke on Trent; the Royal Lancaster Infirmary, Lancaster; and Trafford General Hospital, Manchester. Other hospitals will follow.
Chief investigator Professor Kitas, said: “It has been known for some time that there is a link between rheumatoid arthritis and cardio-vascular mortality. This may be in large part due to early and more advanced blood vessel damage due to high levels of inflammation in RA. Statins lead to a reduction of cardiovascular death rates by reducing cholesterol and possibly inflammation. However, most previous trials of statins have not included patients with rheumatoid arthritis.
“We therefore need to know if statins can reduce the absolute risk of cardio-vascular death rate in RA patients by ten to 15 per cent, and the relative risk by 35 to 40 per cent.”
Statins have been routinely given to people who have had heart attacks to lower the risk of them suffering a second for the past few years. New guidelines from the National Institute for Health and Clinical Excellence (NICE) extended the use of the drugs to an extra three million people with a 20 per cent risk over ten years of developing cardiovascular disease, which can lead to heart attack, angina and stroke.
“One of the problems is that many patients with high cholesterol and blood vessel damage are unaware of it until they have a heart attack or stroke,” added Professor Kitas.
Further information can be found at the TRACE RA (Trial of Atorvastatin in the primary prevention of Cardiovascular Events in RA) trial website: (http://www.dgoh.nhs.uk/tracera) or by contacting the TRACE RA Manager, Hawys Williams on 0161 2755639.
