Effect of lovastatin, an HMG CoA reductase inhibitor, on acute renal allograft rejection

3-Hydroxy-3-methyl glutaryl coenzyme A (HMG CoA) reductase inhibitors are e stablished anti-lipidemic agents. They also exert immunomodulatory effects. Two recent reports suggest that pravastatin may be useful in decreasing th e incidence and severity of acute rejections (ARs) in heart and kidney tran splant recipients. We undertook this prospective, randomized, placebo-contr olled, double blind trial to investigate the effect of lovastatin on acute renal allograft rejection. Sixty-five consecutive, one-haplotype-matched, l iving related first renal transplant recipients were randomized to receive either lovastatin 20 mg/d or placebo for 3 months, in addition to cyclospor ine, azathioprine, and steroids. Lipid levels, AR episodes, and liver and m uscle enzymes were followed for 3 months post-transplant. At the end of the study period, lovastatin had successfully controlled lipid levels. However , there was no effect on AR episodes (15.15% in the treatment group vs. 18. 75% in the placebo group).