Crestor (rosuvastatin) is a type of statin medication, marketed by AstraZeneca. Statins are generally prescribed to lower levels of cholesterol, a fatty substance that can build up in arteries and cause heart and vascular disease.

Crestor is also being investigated as a potential therapy to help manage the symptoms of scleroderma.

How Crestor works

Statins like Crestor reduce cholesterol levels by blocking an enzyme called HMG-CoA reductase that is normally involved in producing cholesterol. Research suggests that statins also target other areas in the body.

The vascular endothelium is a layer of cells in the arteries that is essential in regulating blood flow by causing the arteries to widen or narrow as required, and that is also involved in regulating some immune responses. Statins are thought to directly act on and improve the function of the vascular endothelium.

In scleroderma, damage caused by the immune system mistakenly targeting healthy connective tissue can result in a wide range of problems including scarring of the arteries, causing them to narrow.

Connective tissue damage can also lead to endothelial dysfunction, which causes the arteries to be unable to widen as needed. It can also trigger additional immune processes that result in further damage and scarring of the arteries. This ultimately results in the blood flow being restricted in affected areas, such as fingers and toes, leading to Raynaud’s phenomenon, and the lungs, leading to pulmonary arterial hypertension (PAH).

It is thought that by acting on the endothelium, Crestor may be able to improve blood flow and therefore improve some of the symptoms associated with scleroderma.

Crestor in clinical trials

A Phase 3 clinical trial (NCT00984932) enrolled 46 patients with scleroderma-associated PAH. The patients were randomly assigned to either receive Crestor or a placebo for six months.

The results were presented at the 2009 European League Against Rheumatism (EULAR) Annual European Congress of Rheumatology in Denmark. They showed there was a significant reduction in endothelial injury markers in patients treated with Crestor compared to those given a placebo, suggesting that Crestor helped reduce the progressive damage caused to the arteries in scleroderma-associated PAH.

Furthermore, patients treated with Crestor showed improved exercise capacity (a measure of lung function) and increased blood flow compared to patients given a placebo, suggesting that Crestor may benefit patients in scleroderma-associated PAH.

Another study aimed to assess the effect of 20 mg of Crestor daily for six months in 28 patients with systemic scleroderma. The results, published in the journal Arthritis Research & Therapy, demonstrated that Crestor improved endothelial function.

Patients also showed a significant reduction in immune and inflammatory markers, suggesting that Crestor may reduce the abnormal and damaging immune response in scleroderma.

Other information

Common side effects of Crestor include muscle or joint pain, blocked or runny nose, coughing, stiffness, dry or sore throat, headache, swollen glands in the neck, difficulty swallowing, and voice changes.

Crestor was originally discovered by the Japanese pharmaceutical company Shionogi.

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