Download PDF
Z Geburtshilfe Neonatol 2018; 222(01): 31-33
DOI: 10.1055/s-0044-100789
DGPM-Preisträgerreferat
© Georg Thieme Verlag KG Stuttgart · New York

Pravastatin – Ein Lipidsenker zur Präeklampsie-Prophylaxe und Therapieoption?

Can Pravastatin influence Pregnancies at High-risk for Preeclampsia?
Marie L. Weber
1   Abteilung für Geburtsmedizin, Universitätsklinikum Leipzig
› Author Affiliations
Further Information

Publication History

received 14 December 2017

accepted 08 January 2018

Publication Date:
02 March 2018 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Statine scheinen durch ihre pleiotropen Eigenschaften das inflammatorische, anti-angiogene Milieu bei Schwangerschaften mit zugrundeliegender plazentarer Ischämie zu beeinflussen und können zu einer Erkrankungsprävention beziehungsweise Verzögerung sowie Abmilderung einer Präeklampsie führen. Die Abteilung für Geburtsmedizin des Universitätsklinikums Leipzig plant eine randomisierte, doppelverblindete, plazebokontrollierte Machbarkeitsstudie, um den Effekt von Pravastatin auf das Gestationsalter bei Entbindung, sowie klinische, angiogene und dopplersonografische Parameter bei Hochrisikopatientinnen zu beurteilen.

Abstract

Statins seem to positively influence the inflammatory, anti-angiogenic milieu of pregnancies with underlying placental ischemia by their pleiotropic effects. This might prevent, ameliorate and delay preeclampsia. To confirm the benefits of pravastatin on gestational age at birth as well as clinic and angiogenic markers in pregnancies at high-risk for preeclampsia, the Department of Obstetrics at the University Hospital Leipzig plans a randomized, double-blinded, placebo-controlled feasibility study.

Schlüsselwörter

Präeklampsie - Pravastatin - sFlt-1/PlGF

Key words

Preeclampsia - Pravastatin - sFlt-1/PlGF
 

  • Literatur

  • 1 Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet 2005; 365: 785-799
    CrossrefPubMedGoogle Scholar
  • 2 Roberts JM, Taylor RN, Gold A. Clinical and biochemical evidence of endothelial cell dysfunction in the pregnancy syndrome preeclampsia. Am J Hypertens 1991; 4: 700-708
    CrossrefPubMedGoogle Scholar
  • 3 McDonald SD, Malinowski A, Zhou Q. et al. Cardiovascular sequelae of preeclampsia/eclampsia: a systematic review and meta-analyses. Am Heart J 2008; 156: 918-930
    CrossrefPubMedGoogle Scholar
  • 4 Cudmore M, Ahmad S, Al-Ani B. et al. Negative regulation of soluble Flt-1 and soluble endoglin release by heme oxygenase-1. Circulation 2007; 115: 1789-1797
    CrossrefPubMedGoogle Scholar
  • 5 Ramma W, Ahmed A. Therapeutic potential of statins and the induction of heme oxygenase-1 in preeclampsia. J Reprod Immunol 2014; 101–102: 153-160
    PubMedGoogle Scholar
  • 6 Brownfoot FC, Tong S, Hannan NJ. et al. Effects of Pravastatin on Human Placenta, Endothelium, and Women With Severe Preeclampsia. Hypertension 2015; 66: 687-697
    CrossrefPubMedGoogle Scholar
  • 7 U.S Food and Drug Administration. Available at: http://www.fda.gov. Accessed May 3, 2016
    PubMed
  • 8 Dostal LA, Schardein JL, Anderson JA. Developmental toxicity of the HMG-CoA reductase inhibitor, atorvastatin, in rats and rabbits. Teratology 1994; 50: 387-394
    CrossrefPubMedGoogle Scholar
  • 9 Colvin L, Slack-Smith L, Stanley FJ. et al. Linking a pharmaceutical claims database with a birth defects registry to investigate birth defect rates of suspected teratogens. Pharmacoepidemiol Drug Saf 2010; 19: 1137-1150
    CrossrefPubMedGoogle Scholar
  • 10 Bateman BT, Hernandez-Diaz S, Fischer MA. et al. Statins and congenital malformations: cohort study. Br Med J 2015; 350: h1035
    CrossrefPubMedGoogle Scholar
  • 11 Nanovskaya TN, Patrikeeva SL, Paul J. et al. Transplacental transfer and distribution of pravastatin. Am J Obstet Gynecol 2013; 209: 373
    PubMedGoogle Scholar
  • 12 Bauer AJ, Banek CT, Needham K. et al Pravastatin attenuates hypertension, oxidative stress, and angiogenic imbalance in rat model of placental ischemia-induced hypertension. Novelty and significance. Hypertension 2013; 61: 1103-1110
    CrossrefPubMedGoogle Scholar
  • 13 Elahi MM, Cagampang FR, Ohri SK. et al. Long-term statin administration to dams on high-fat diet protects not only them but also their offspring from cardiovascular risk. Ann Nutr Metab 2013; 62: 250-256
    CrossrefPubMedGoogle Scholar
  • 14 Costantine MM, Cleary K, Hebert MF. et al. Safety and pharmacokinetics of pravastatin used for the prevention of preeclampsia in high-risk pregnant women: a pilot randomized controlled trial. Am J Obstet Gynecol 2016; 214: 720.e1-720.e17
    CrossrefPubMedGoogle Scholar
  • 15 Lefkou E, Mamopoulos A, Fragakis N. et al. Clinical improvement and successful pregnancy in a preeclamptic patient with antiphospholipid syndrome treated with pravastatin. Hypertension 2014; 63: e118-e119
    CrossrefPubMedGoogle Scholar
  • 16 Otten LA, Van der Ven K, Kühr M. et al. Pravastatin for prevention of HELLP syndrome. A case report. Medicine 2017; 96: 42
    PubMedGoogle Scholar
  • 17 https://www.clinicaltrialsregister.eu/ctr-search/trial/2009-012968-13/GB
    PubMed
  • 18 Poon LC, Wright D, Rolnik DL. et al Aspirin for Evidence-Based Preeclampsia Prevention trial: effect of aspirin in prevention of preterm preeclampsia in subgroups of women according to their characteristics and medical and obstetrical history. Am J Obstet Gynecol 2017; 217: 585.e1-585.e5
    CrossrefPubMedGoogle Scholar