Pregnancy loss associated with antiphospholipid antibodies might be prevented with statin drugs, said researchers here. In a mouse model of antiphospholipid syndrome, treatment with simvastatin (Zocor) and pravastatin (Pravachol) reduced miscarriage by approximately 70%, reported Guillermina Girardi, Ph.D., of the Hospital for Special Surgery, and colleagues in the October issue of the Journal of Clinical Investigation. "We postulate that statins may be a good treatment for women with antiphospholipid-induced pregnancy complications," they wrote. In an interview, Dr. Girardi said her institution is planning to begin clinical trials of statins in women with antiphospholipid antibodies. But she urged clinicians to await the outcome of clinical studies before prescribing them for this purpose.
Antiphospholipid antibodies are seen in 3% to 7% of women of child-bearing age. They have traditionally been associated with excessive blood coagulation and thrombosis, and treatment has typically involved anti-coagulants such as warfarin.
Excessive clotting has been thought to trigger miscarriages by creating placental infarctions, killing the fetus.
But recent studies have suggested that the coagulation dysfunction may be secondary to an inflammatory process and is not the true cause of fetal loss.
In particular, antiphospholipid antibodies appear to activate the C5a complement pathway, inducing expression of tissue factor, which has both pro-coagulant and pro-inflammatory properties.