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THU0150 Use of Methotrexate in Patients with Recent Onset Rheumatoid Arthritis Alter Serum Cholesterol and Triglyceride Levels
  1. J. Calvo Gutiérrez1,2,
  2. R. Ortega Castro1,2,
  3. R. Jimenez Gasco1,
  4. P. Font Ugalde1,2,
  5. M.C. Castro Villegas1,2,
  6. A. Escudero Contreras1,2,
  7. E. Collantes Estevez1,2
  1. 1Dpt of Rheumatology, Reina Sofía Hospital, Cόrdoba
  2. 2Motion Analysis Laboratory, Maimonides Institute for Biomedical Research (IMIBIC), Cόrdoba, Spain

Abstract

Background Studies in RA show that a high rate of inflammation correlates with low serum lipids and after intensive treatment to reduce the proinflammatory state, lipids tend to increase (1), being only increased triglyceride levels which were significantly associated with the presence of CVD (2). In patients with early-stage RA, inflammatory markers are elevated and lipids affect both quantitatively (usually decreased) and qualitatively (subfractions are altered (3). Navarro-Millán (4) showed that the use of methotrexate (mtx) for 24 weeks increased lipid levels, although its use is associated with a trend towards reduction of CVD and that is why it has been suggested that presents cardioprotective properties and producing no effect on the characteristics of lipids (5)

Objectives To assess the influence of mtx use in cholesterol (col), triglycerides (Tg) and hemoglobin (Hb) levels, in a cohort of patients with recent-onset RA for 5 year follow-up and record the presence or absence of CVD.

Methods Longitudinal observational study that included 50 patients diagnosed with RA (ACR criteria/EULAR 2010) of less than 6 months from the onset of symptoms and who had started treatment with mtx or hydroxychloroquine (hcq). The presence or absence of CVD baseline was recorded and performed analytical control (no treatment), at one and five years of follow up. Clinical activity as DAS28 (ESR) and Hb levels, Col ang Tg after initiation of treatment was compared in both groups (mtx or hqc).

Results 72% were women with a mean age of 50.39±16.13 years and an average duration of disease less than six months. 64% started treatment with mtx with an average dose of 9.08±1.89 mg/week. The proportion of smoking, hypertension and diabetes was low, although the inflammatory burden was high with an average DAS28>4. The mean total and basal Tg and Col levels was 199.18±37.48 mg/dl and 95.60±46,65mg/dl respectively, both being within normal limits, as well as the mean Hb levels (12.54±1.81 g/dl). During follow any CVD was not described in any of the groups. When comparing the change in the levels of Col and Hb at one and five years compared to baseline in both groups, no significant differences were found, maintaining stable serum levels before and after the introduction of treatment; we found reduced levels of TG in mtx- group at one year follow-up (p<0.05). We also observed a significant reduction in clinical activity as DAS28 when compared with baseline, on a similar way in both groups. (p<0.01).

Conclusions We could conclude that the introduction of mtx in patients with recent-onset RA improves clinical activity and the underlying inflammation without an increase in the levels of total Col or EVC development. There is a decrease in Tg levels significantly when compared with the use of hcq, which corroborate its cardioprotective profile.

References

  1. Chioy E, Satter. Ann Rheum Dis 2009; 68 (4):460-9.

  2. Myasoedova E y col. Ann Rheum Dis 2011;70 (3)482-7

  3. Georgiadis AN y cols. Arthritis Res Ther 2006; 8 (3):R82

  4. Navarro-Millan I y Cols. Arthritis Rheum 2013; 65 (6):1430-8

  5. Micha R y Cols. Ann J Cardial 2011; 108(9):1362-70

Disclosure of Interest None declared

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