Background Rheumatoid arthritis (RA) patients present increased mortality due to cardiovascular (CV) events, particularly by inflammation in addition to traditional CV risk factors (mainly changes in lipid profile). Although anti-TNF agents have been proven effective in controlling joint damage and systemic inflammation, nowadays there is still controversy about the real effect of anti-TNF treatment on the lipid profile.
Objectives The aim of this study is to evaluate the evolution of the lipid profile after the onset of anti-TNF therapy.
Methods Eighty RA patients (65 female, age 53±13 years, disease duration 7±5 years), who failed treatment with DMARDs, have been enrolled in this study, and evaluated, before and at 24 and 52 weeks from the start of anti-TNF treatment, for the following lipid profile: Total-cholesterol (Tot-C), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), triglycerides (TG), and cholesterol risk ratio (CRR) [Tot-C/HDL-C] was also calculated. At the same time the disease activity scores CDAI, SDAI, DAS44 and DAS28, four variables, were assessed. Twenty-nine patients were treated with etanercept, 19 with adalimumab, 18 with infliximab, 7 with certolizumab-pegol and 7 with golimumab.
Results The levels of Tot-C, HDL-C, LDL-C and TG, as well as CRR, didn’t significantly changed during the follow-up period of treatment. Considering the disease activity according to CDAI, SDAI, DAS44 and DAS28, about 50% of patients achieved low disease activity/remission state after 24weeks and about 60% achieved this state after 52 weeks of treatment. In this latter group of patients we observed significantly lower levels of Tot-C, LDL-C, and TG, and a lower CRR compared to those observed in patients with moderate/high disease (see Table). No significant differences were found between the anti-TNF evaluated.
Conclusions Our study suggest that anti-TNFα treatment per se do not interfere with the lipid profile of RA patients. While according to response to TNFα treatment, assessed by CDAI, SDAI, DAS44 or DAS28, patients that achieved low disease activity/remission seems to have a protective lipid profile for CV events, so a better control of the disease can also affect the lipid metabolism.
Disclosure of Interest None Declared
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