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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2019.tde-14112019-165317
Document
Author
Full name
Isabela Bruna Pires Borges
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2019
Supervisor
Committee
Shinjo, Samuel Katsuyuki (President)
Borba Neto, Eduardo Ferreira
Souza, Fernando Henrique Carlos de
Torigoe, Dawton Yukito
Title in Portuguese
O uso da atorvastatina é seguro em pacientes com miopatias autoimunes sistêmicas?: estudo prospectivo, duplo cego, randomizado e controlado
Keywords in Portuguese
Dermatomiosite
Dislipidemias
Estatinas
Miosite
Polimiosite
Síndrome antissintetase
Abstract in Portuguese
Objetivo: O uso de drogas hipolipemiantes, como as estatinas, no tratamento da dislipidemia em pacientes com miopatias autoimunes sistêmicas (MAS) é comprometido pela baixa qualidade das evidências de relatos de casos e por um estudo retrospectivo. Portanto, avaliamos em um estudo prospectivo, randomizado, duplo-cego, controlado por placebo, o impacto da atorvastatina em pacientes com MAS na mialgia e outros efeitos colaterais, perfil lipídico e status da doença. Métodos: Estudo prospectivo, randomizado, duplo-cego, controlado, no qual 24 pacientes com MAS e dislipidemia foram avaliados entre 2017 e 2019. Os pacientes foram randomizados (2:1) em dois grupos: atorvastatina e placebo. Todos os pacientes foram avaliados no início e na 12ª semana para os seguintes parâmetros do International Myositis Assessment & Clinical Studies Groups (IMACS). Resultados: A média de idade dos pacientes foi de 49,0±10,0 anos, sendo 75% do sexo feminino, com mediano de tempo de doença de 5,5 (3,3-11,8) anos. Todos os pacientes apresentavam os valores de IMACS próximos da normalidade. No início do estudo, os dados demográficos, status das doenças, esquema terapêutico, comorbidades cardiovasculares e seus fatores de risco foram comparáveis entre os grupos atorvastatina e placebo (P > 0,05). Após 12 semanas de seguimento, ao comparar o grupo atorvastatina com placebo, foi observada uma redução dos níveis de LDL-colesterol: 95,5 (79,3-134,5) vs. 135,0 (123,0-174,6) mg/dL, respectivamente, P=0,011. Em relação às outras variáveis avaliadas, não houve diferença estatística (P > 0,05). Durante o estudo, não houve intercorrências clínicas relevantes. Conclusões: O uso da atorvastatina foi seguro e eficaz nos pacientes estáveis com MAS e com dislipidemia. Estudos adicionais, com casuística maior e pacientes com diferentes níveis de atividade de doença, são necessários para corroborar com os dados do presente estudo
Title in English
Is atorvastatin safe to patients with systemic autoimmune myopathies?: a prospective, randomized, double-blind, placebo-controlled study
Keywords in English
Antisynthetase syndrome
Dermatomyositis
Dyslipidemias
Myositis
Polymyositis
Statins
Abstract in English
Objective: The use of lipid-lowering drugs, such as statins, to treatment of dyslipidemia in patients with systemic autoimmune myopathies (SAMs) is hampered by the low quality of evidence of case reports and one retrospective study. We therefore assessed in a prospective, randomized double-blinded placebo controlled study design the impact of atorvastatin in SAMs patients on myalgia and other side-effect, lipid profile and disease status. Methods: A prospective, double-blinded, randomized, controlled study in which 24 patients with SAMs and dyslipidemia had evaluated between 2017 and 2019. Patients were randomized (2:1) into two groups: atorvastatin and placebo. All patients were evaluated at baseline and 12 weeks for the International Myositis Assessment & Clinical Studies Groups (IMACS) set scores. Results: The mean age of the patients was 49.0±10.0 years, being 75% female, with a median disease time of 5.5 (3.3-11.8) years. All patients presented IMACS values close to normal. At baseline, demographic data, disease status, treatment, cardiovascular comorbidities, and risk factors were comparable between the atorvastatin and placebo groups (P > 0.05). After 12 weeks of follow-up, when comparing the atorvastatin group with placebo, we observed a reduction in LDLcholesterol levels: 95.5 (79.3-134.5) vs. 135.0 (123.0-174.6) mg/dL, respectively (P > 0.011). In relation to the other variables evaluated, there was no statistical difference (P > 0.05). During the study, there were no relevant clinical intercurrences. Conclusions: The use of atorvastatin was safe and effective in patients stable with SAMs and with dyslipidemia. Additional studies, with a larger sample and patients with different levels of disease activity, are necessary to corroborate with the data of the present study
 
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Publishing Date
2019-11-18
 
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