RT Journal Article
SR Electronic
T1 Modulation of lipoprotein plasma concentrations during long-term anti-TNF therapy in patients with active rheumatoid arthritis
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 1503
OP 1507
DO 10.1136/ard.2006.066191
VO 66
IS 11
A1 Calin Popa
A1 Frank H J van den Hoogen
A1 Timothy R D J Radstake
A1 Mihai G Netea
A1 Agnes E Eijsbouts
A1 Martin den Heijer
A1 Jos W M van der Meer
A1 Piet L C M van Riel
A1 Anton F H Stalenhoef
A1 Pilar Barrera
YR 2007
UL http://ard.bmj.com/content/66/11/1503.abstract
AB Objective: Durable blockade of tumour necrosis factor-alpha (TNF-α) in patients with rheumatoid arthritis (RA) suppresses disease activity and its progression. Cardiovascular diseases are 1.5–2-fold more frequent in RA patients than in the general population. Although TNF-α has well-established effects on lipid metabolism, the long-term effects of TNF-α blockade on lipid pattern are still unclear. In the present study, we investigated the effects of 1-year therapy with anti-TNF on the lipid profile of RA patients.Methods: Disease activity (DAS28) and plasma lipoproteins concentrations (total, HDL and LDL-cholesterol, triglycerides, ApoA, ApoB) were assessed in 55 RA patients and 55 controls. The whole RA group was followed up for 6 months, and 31 of the patients were followed up for 1 year.Results: In RA patients, DAS28 decreased after 2 weeks from the start of therapy (p<0.001) and remained low during the entire study duration. Short-term effects of anti-TNF on plasma lipid concentrations seemed beneficial and anti-atherogenic. However, these changes did not persist: plasma concentrations of total and LDL-cholesterol and the atherogenic index increased after 6 months and 1 year from the start of therapy. During therapy, the changes in disease activity and inflammatory status were inversely correlated with changes in plasma total and HDL cholesterol levels and positively correlated with the variation of atherogenic index.Conclusion: We conclude that one-year therapy with infliximab is likely to lead to a more pro-atherogenic pattern of the plasma lipids concentrations. However, the overall impact of these changes on the cardiovascular risk is more complex, considering the strong anti-inflammatory effects of anti-TNF drugs.