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THU0092 Effect of Disease Modifying anti Rheumatic Drug Methotrexate on The Lipid Profile of Patients with Rheumatoid Arthritis
  1. G.S. Sidhu
  1. rheumatology, Sir ganga ram hospial, New Delhi, delhi, India

Abstract

Background Cardiovascular morbidity and mortality appear to be increased in rheumatoid arthritis (RA), which might be due to increased prevalence of risk factors for cardiovascular disease, such as an accelerated progression of atherosclerosis. Patients with active RA frequently show an atherogenic lipid profile, which has been linked with the inflammatory reaction.

Objectives The AIM of this study is to determine the effect of treatment with methotrexate on the lipid profile of patients with rheumatoid arthritis.

Methods We studied 25 patients with newly diagnosed rheumatoid arthritis who had not been treated with corticosteroids or disease-modifying antirheumatic drugs. We measured serum lipid profile of patients, who achieve remission according to DAS28 scores, at baseline and 3, 6 and 12 months post methotrexate to study the effect of the drug on the lipid levels.

Results Twenty five patients were included in this prospective study 22 females (88%) and 3 males (12%). The mean age of patients was (46.40 ± 13.00). In these patients, mean high density lipoprotein (HDL) increased by 18.8 ± 11.3% (p<0.001), 21.9 ± 12.5% (p<0.001) and 26.8 ± 12.3% (p<0.001) and total cholesterol (TC) increased by 16.39 ± 22.12% (p<0.001), 14.38 ± 18.18% (p<0.001) and 12.94 ± 16.81% (p<0.001) at 3, 6, and moths respectively. Increase in Light density lipoprotein (LDL) was statistically significant at 3 months {9.89 ± 18.84% (p<0.042)} where as significant decrease in the level of triglycerides was noted at 6 months 2.69 ± 3.94% (p<0.003) and at 12 months2.62 ± 4.52% (p<0.010). Despite the increase in HDL, LDL and TC the atherogenic ratios (TC/HDL and LDL/HDL ratios) showed improvement at 3, 6 and 12 months post MTX treatment. There was negative association between changes in DAS28(ESR) after 3 months therapy and changes in HDL, LDL and TC levels.

Conclusions Lipid profile and atherogenic ratios (TC/HDL and LDL/HDL ratios) improves substantially following effective treatment with methotrexate of rheumatoid arthritis. This improvement may reduce the risk of cardiovascular disease. With a decline in disease activity, a rising trend was observed for all lipids. However, changes in disease activity (DAS28) were only significantly related to changes in HDL cholesterol and LDL cholesterol levels.

Acknowledgement I dedicate this thesis to my beloved parents; my father Jeet Singh Sidhu and my mother Amarjit kaur.

Disclosure of Interest G. sidhu Shareholder of: no, Grant/research support from: no, Consultant for: no, Employee of: no, Paid instructor for: no, Speakers bureau: no

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