Do bisphosphonates and statins have a role in spondyloarthritis management?
Bisphosphonates and statins target the mevalonate pathway of biosynthesis of prenyl groups, which are necessary for the lipid modification of small GTP-binding proteins (eg, Ras, Rac, Rho) that transduce a wide array of extracellular growth and differentiation signals from cell surface receptors to the nucleus. Interference with this pathway has been shown to confer beneficial anti-inflammatory properties in vitro and in animal models of inflammation. Primarily open-label data in spondylo-arthritis suggests mild to moderate efficacy on symptoms and function but their primary clinical role may be as adjunctive therapy to manage systemic osteoporosis and risk for cardiovascular events.
