Rheumatoid arthritis is characterised by uncontrolled chronic inflammation of the joints, which leads to their destruction and functional disability. It is also associated with increased and early cardiovascular mortality. This is thought to be linked to chronic systemic inflammation, which can lead to accelerated atherosclerosis, and thus earlier and more severe CHD. The beneficial effects of statins in the primary and secondary prevention of CHD are well-established. These are not only due to their lipid-lowering properties. Statins have several anti-inflammatory and immunomodulatory effects through which they may modify the inflammatory mechanisms involved in the generation and rupture of atherosclerotic plaques. These effects may also be useful for controlling rheumatoid inflammation. Thus statins may be an important adjunctive therapy in RA, aiming to both reduce joint inflammation and improve cardiovascular outcome. This needs to be tested in randomised controlled trials designed specifically for the purpose.
