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Biological effects of statins in systemic sclerosis: a systematic review and meta-analysis of 323 patients

In brief

Statins lower CRP by about 0.7 mg/L in systemic sclerosis

A meta-analysis of ten studies (323 patients) found that statin therapy reduced inflammatory markers-CRP fell by roughly 0.7 mg/L, IL-6 by 5.5 pg/mL, and fibrinogen by 40 mg/dL-and also modestly improved endothelial markers. While biochemical changes are clear, no meaningful clinical benefit was demonstrated, and larger randomized trials are needed to define any therapeutic role.

Journal
Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences (Q2)
Published
14 August 2026
Study design
Systematic review / meta-analysis of RCTs
Evidence level
Level 1, High (CEBM 1a)
Authors
Mostafa A Khalifa, Hamzah M Alghzawi, Shehabeldin S Anan, Ahmad Al Rifai, Ayah A Anwar, Hayder Ali Raheem Al-Saedi, et al.
PMID
42599596
DOI
10.1007/s40199-026-00639-5

Why clinicians should know about it

Abstract

INTRODUCTION: Systemic sclerosis (SSc) is driven by persistent inflammation and microvascular damage. Statins are hypothesized to offer vasculoprotective effects beyond lipid-lowering. We systematically evaluated the efficacy and safety of statins in SSc across biochemical, vascular, and patient-centred outcomes. METHODS: Following PRISMA guidelines, a systematic search of four electronic databases was conducted up to August 2025. Ten studies involving 323 patients were included. Pooled estimates were calculated using a random-effects model. Heterogeneity and sensitivity analyses were performed, and study quality was assessed using standardized appraisal tools. RESULTS: Statin therapy was associated with significant biochemical improvements. Compared with baseline or placebo, CRP decreased by an average of 0.70 mg/L, IL-6 by 5.56 pg/mL, and fibrinogen by 40 mg/dL. Endothelial markers showed similar reductions: 0.85 pg/mL for ET-1, 23.17 IU/dL for vWF, and 25 ng/mL for ICAM-1. Total cholesterol and LDL decreased by mean differences of 0.93 mmol/L and 0.76 mmol/L, respectively, while HDL showed no meaningful change. CONCLUSION: Statins improve inflammatory and endothelial pathways in systemic sclerosis, but these findings should be interpreted cautiously, as clinical benefits remain minimal. Randomized trials are required to further study statins' therapeutic role beyond biochemical modulation.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.