Objectives:To evaluate the effects of infliximab and corticosteroid therapy on the lipid profile in patients with active rheumatoid arthritis (RA).
Methods:Infliximab infusions were given at week 0, 2, 6 and then every 8 weeks. Prior to each infusion, disease activity parameters (DAS-28, CRP) and lipid levels (total-, high-density lipoprotein (HDL) cholesterol, triglycerides, apolipoprotein A-1 (Apo A-1) and apolipoprotein B) were measured in 80 consecutive RA patients, who completed the study period of 48 weeks. Longitudinal analyses were used to investigate  the course of lipid levels over a period of time and  the relationship between lipids, prednisone dose and disease activity.
Results:Infliximab treatment causes a significant reduction in disease activity and a concomitant decrease of prednisone dose. Although they initially improved significantly, all lipid levels had returned to baseline levels after 48 weeks, except for Apo A-1. Longitudinal analyses reveal significant yet opposite associations between lipid levels and disease activity and between lipid levels and prednisone dose. DAS-28 improvement by 1 point is associated with an increase of 0.016 mmol/l (0.618 mg/dl) total- and 0.045 mmol/l (1.737 mg/dl) HDL cholesterol. Reduction of 10 mg prednisone is associated with a decrease of 0.04 mmol/l (1.544 mg/dl) total- and 0.16 mmol/l (6.177 mg/dl) HDL cholesterol.
Conclusion:Overall, no changes in serum lipid levels were observed after 48 weeks of infliximab treatment. The initial beneficial effects of infliximab on the lipid profile, by means of a reduction of disease activity, are attenuated by a concomitant decrease in prednisone dose.
- disease activity
- immunosuppressive treatment
- lipid profile
- rheumatoid arthritis