Effects of Rosuvastatin on Carotid Artery Plaques in Patients With Inflammatory Joint Disease
Condition: Carotid Artery Plaque; Ankylosing Spondylitis; Rheumatoid Arthritis
MeSH terms: Spondylitis; Arthritis; Arthritis, Rheumatoid; Spondylarthritis; Spondylitis, Ankylosing; Joint Diseases; Carotid Stenosis
Study type: Interventional

Summary: 
      Patients with rheumatoid Arthritis (RA) and Ankylosing Spondylitis (AS) are at greater risk
      of developing cardiovascular disease. The reason(s) for this have not been well investigated,
      but there is a general understanding that systemic inflammation plays a part in the increased
      cardiovascular morbidity and mortality. In spite of the increased risk in these patients,
      they have not been included as a high risk patient group in cardiovascular prevention
      guidelines.

      The investigators have carried out a cardiovascular study of RA and AS patients, as well as
      patients with arthritis for the first time. The investigators have demonstrated cholesterol
      plaques in the carotid artery in some of these patients. Plaques in the carotid artery
      represent a risk for development of cerebral stroke and are significantly associated with
      myocardial infarction. These plaques, which are asymptomatic and do not cause
      haemodynamically significant narrowing, diameter reduction (i.e. operation is not indicated),
      are vascular atheromatous disease. Therefore, according to prevailing cardiovascular
      guidelines (SCORE 2007), these patients shall have secondary prevention with a lipid lowering
      agent with the LDL-cholesterol goal of 1.8 mmol/L and HDL-cholesterol > 1.0 mmol/L for men
      and > 1.1 mmol/L for women.

      Statins are cholesterol-lowering drugs, and have been shown to reduce the risk of
      cardiovascular disease significantly. In addition, reduction in the size of coronary plaques
      has been induced by statins, when the LDL has been reduced to 1.6-1.8 mmol/l. Plaques in the
      carotid or coronary arteries have not previously been treated and characterized in patients
      with RA, AS and other inflammatory forms of arthritis.

      The aim of this study is to treat patients with cholesterol plaques in the carotid artery
      with cholesterol-lowering medication, in the form of Rosuvastatin for 18 months, and
      characterize the effects on the plaques in the carotid and coronary arteries. In addition,
      the investigators want to clarify the connection between plaques in the carotid and coronary
      arteries in patients with RA, AS and other inflammatory forms of arthritis.
    


Intervention name(s): Rosuvastatin
Intervention type(s): Drug
Intervention description(s): All the patients who have signed the informed consent will after they have had performed a MCT and possibly SCC with an IVUS, will be give Rosuvastatinuntill their LDL level has reached 1.6-1.8 mmol/l. The objective is that all the participants should have reached 1.6-1.8 mmol/l 3 months after the start of the study. The participants will remain on Rosuvastatin medication for a total of 18 months.
Other intervention name(s): Brand name for Rosuvastatin is Crestor
Intervention MeSH terms: Rosuvastatin Calcium
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Keywords: Carotid plaques; inflammatory joint disease; statins; inflammation; lipoprotein components