PMID- 16855168
OWN - NLM
STAT- MEDLINE
DCOM- 20060823
LR  - 20140729
IS  - 0077-8923 (Print)
IS  - 0077-8923 (Linking)
VI  - 1069
DP  - 2006 Jun
TI  - Effects of anti-TNF-alpha treatment on lipid profile in patients with active 
      rheumatoid arthritis.
PG  - 414-9
AB  - 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. Tumor necrosis factor-alpha 
      (TNF-alpha), a pivotal proinflammatory cytokine implicated in the pathogenesis of 
      atherosclerosis in RA, may be involved in the development of the altered lipid 
      profile observed in active RA. Our aim was to investigate the effects of 
      anti-TNF-alpha treatment in combination with methotrexate (MTX) and 
      corticosteroid therapy on lipid profile in patients with active RA. In this 
      prospective study 34 consecutive RA patients were included (all women, mean age 
      51.6 +/- 7.9 years, range 46-72 years) with active (defined as Disease Activity 
      Index 28 joint score [DAS-28], of at least 3.2) and refractory RA, in stable 
      treatment with MTX (7.5-10 mg/week) and prednisone (7.5-10 mg/day) for 3 months. 
      All patients received TNF-alpha blockers (n = 16, etanercept 25 mg twice weekly; 
      n = 14, infliximab 3 mg/kg on 0, 2, 6, and every 8 weeks thereafter; and finally, 
      n = 4, adalimumab 40 mg every other week). Total cholesterol, high-density 
      lipoprotein cholesterol (HDL cholesterol), triglycerides (TG) and lipoprotein (a) 
      [Lp(a)] levels and the atherogenic index (ratio cholesterol/HDL cholesterol) were 
      measured at base line, and at 16 and 24 weeks. Results were as follows: The 
      DAS-28 was 6.9 +/- 2.1 at base line and decreased to 4.6 +/- 1.8 after 16 weeks, 
      and further to 4.1 +/- 1.3 after 24 weeks (both, P < 0.01). Following 
      anti-TNF-alpha treatment, the mean levels of total cholesterol were 168 +/- 24 
      mg/dL at base line and increased to 188 +/- 28 mg/dL at 16 weeks (P < 0.01), and 
      197 +/- 26 mg/dL at 24 weeks (P < 0.001). However, also the mean levels of HDL 
      cholesterol were significantly higher than basal values after 16 and 24 weeks of 
      treatment (34 +/- 12 mg/dL versus 36 +/- 18 mg/dL [P < 0.05] and 38 +/- 14 mg/dL 
      [P < 0.01], respectively). TG and Lp(a) levels, as well as the atherogenic index 
      were not significantly changed. Interestingly, variations in disease activity 
      were significantly and inversely correlated with HDL cholesterol levels. IN 
      CONCLUSION: Short anti-TNF-alpha treatment was associated with a significant 
      increase of both total cholesterol and HDL cholesterol levels, and correlated 
      with decreased disease activity. The atherogenic index showed no changes during 
      the study. Therefore, anti-TNF-alpha treatment might affect lipid profile in RA 
      patients.
FAU - Seriolo, Bruno
AU  - Seriolo B
AD  - Division of Rheumatology, Department of Internal Medicine and Medical 
      Specialities, University of Genova, Genova, Italy. seriolob@unige.it
FAU - Paolino, Sabrina
AU  - Paolino S
FAU - Sulli, Alberto
AU  - Sulli A
FAU - Fasciolo, Daniela
AU  - Fasciolo D
FAU - Cutolo, Maurizio
AU  - Cutolo M
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Ann N Y Acad Sci
JT  - Annals of the New York Academy of Sciences
JID - 7506858
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Cholesterol, HDL)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
MH  - Adrenal Cortex Hormones/*therapeutic use
MH  - Aged
MH  - Arthritis, Rheumatoid/*drug therapy/*metabolism/pathology
MH  - Cholesterol, HDL/blood
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Lipid Metabolism/*drug effects
MH  - Methotrexate/*therapeutic use
MH  - Middle Aged
MH  - Tumor Necrosis Factor-alpha/*antagonists & inhibitors/*metabolism
EDAT- 2006/07/21 09:00
MHDA- 2006/08/24 09:00
CRDT- 2006/07/21 09:00
PHST- 2006/07/21 09:00 [pubmed]
PHST- 2006/08/24 09:00 [medline]
PHST- 2006/07/21 09:00 [entrez]
AID - 1069/1/414 [pii]
AID - 10.1196/annals.1351.039 [doi]
PST - ppublish
SO  - Ann N Y Acad Sci. 2006 Jun;1069:414-9. doi: 10.1196/annals.1351.039.