The pleiotropic effects of statins, especially the anti-inflammatory and immunomodulatory ones, indicate that their therapeutic potential might extend beyond cholesterol lowering and cardiovascular disease to other inflammatory disorders such as rheumatoid arthritis. Therefore, we undertook a prospective cohort study to evaluate the efficacy and safety of simvastatin used for inflammation control in patients with rheumatoid arthritis. One hundred patients with active rheumatoid arthritis divided into two equal groups (the study one who received 20？mg/day of simvastatin in addition to prior DMARDs and the control one) were followed up over six months during three study visits. The results of the study support the fact that simvastatin at a dose of 20？mg/day has a low anti-inflammatory effect in patients with rheumatoid arthritis with a good safety profile. 1. Introduction Since their discovery in 1976, 3-hydroxy-3methylglutaryl-coenzyme A reductase inhibitors (or statins) have emerged as the leading therapeutic regimen for treating hypercholesterolemia modifying, an important cardiovascular risk factor with subsequent reduction of cardiovascular morbidity and mortality [1]. Numerous clinical studies have demonstrated the efficiency of statins in this context, in both primary [2–4] and secondary prevention strategies [5–17]. In parallel, it has become increasingly apparent that the beneficial effects of statins in cardiovascular pathology cannot be ascribed solely to their lipid-lowering properties, but also to another mode of action. These so-called “pleiotropic effects” which encompass modification of endothelial function, plaque stability and thrombus formation, and anti-inflammatory and immunomodulatory properties indicate that the therapeutic potential of statins might extend beyond cholesterol lowering and cardiovascular disease to other inflammatory disorders or conditions such as transplantation, multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus, and chronic kidney disease [18]. Extensive in vitro [19, 20] and in vivo [21–25] data sets support this statement. Rheumatoid arthritis, the commonest of the inflammatory arthritides, is a chronic, systemic, inflammatory disorder which has as primary target the synovial tissue. The characteristic of rheumatoid arthritis is the persistent inflammation of the peripheral joints which leads to pain, stiffness, and swelling, with their gradual destruction, and, in time, it may lead to joint deformities and functional disability. Although the majority of physicians’ efforts had been
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