Lovastatin-induced lupus erythematosus

Article Abstract:

Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of connective tissue that affects the skin, joints, kidneys, nervous system, and mucous membranes. The cause of SLE is not known, but it is thought to involve an autoimmune process in which the body inappropriately produces antibodies against itself (autoantibodies). Patients receiving medication for a prolonged period of time may develop a syndrome that closely mimics SLE. Isolated cases of this type of reaction have been reported following treatment with the cholesterol-lowering drug lovastatin. Two additional cases of a relatively severe SLE-like syndrome are reported. In the first, a 64-year-old woman with primary hypercholesterolemia (elevated blood levels of cholesterol) had been receiving lovastatin since 1988 under strict medical supervision, with no apparent adverse reaction. There was no history or evidence of alcohol or tobacco consumption; and no other drugs were being administered concomitantly. In July 1990, the patient developed a dry cough and severe arthritis in a number of joints, severe enough that she remained homebound and bedridden. In addition, she developed mild jaundice, malaise, fever, and severe nausea. No joint abnormalities were seen with X-ray evaluation. Blood tests for the type of autoantibodies common in SLE were positive. Following discontinuation of lovastatin therapy, the symptoms disappeared, blood chemistry normalized, and there was no recurrence of the symptoms during six months of follow-up. The second case involved a 40-year-old severely hypercholesterolemic man whose cholesterol levels were not normalized by dietary or exercise therapy. Lovastatin therapy was initiated, with a subsequent reduction in cholesterol levels and no apparent side effects. However, in September 1989, the patient complained of a two-month history of fatigue, arthritis-like symptoms, and muscle aches. Once again, antibodies characteristic of SLE were found in the blood. Lovastatin therapy was immediately discontinued, and within two weeks the symptoms had dissipated; blood tests performed over the next six weeks showed no autoantibodies. In the following year, there was no recurrence of the SLE-like symptoms. Hence, lovastatin, at doses used to lower cholesterol levels, can cause a syndrome similar to SLE in a subgroup of patients; the symptoms of this drug-induced condition subside with discontinuation of lovastatin. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Autoimmunity, Lupus erythematosus

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Efficacy and tolerability of lovastatin in 3390 women with moderate hypercholesterolemia

Article Abstract:

Lovastatin is a safe and effective treatment for hypocholesterolemia in women. High levels of low-density lipoprotein (LDL) cholesterol are associated with the development of heart disease. There have been few studies that explored the effects of drug therapy on elevated levels of cholesterol in women. In this study, postmenopausal women were randomly assigned to receive one of four possible lovastatin regimens or a placebo. The participants were followed for 48 weeks. Using National Cholesterol Education Program guidelines, 82% of the women with less than two coronary heart disease risk factors reached the recommended LDL cholesterol levels after treatment with a minimum dose of lovastatin. Of those treated with higher doses of lovastatin (80 mg/day), 95% reached the recommended LDL levels. Side effects were infrequent. The efficacy of lovastatin did not appear to be affected by estrogen-replacement therapy.

Health aspects, Evaluation, Women, Women's health

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