Effects of anti-TNF-α treatment on lipid profile in rheumatic diseases: an analytical cohort study

Abstract

BackgroundThe aim was to assess the influence of long-term treatment with tumor necrosis factor alpha (TNF-α) inhibitors on total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and atherogenic index (AI) in rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) patients.MethodsA retrospective cohort study was conducted on RA, PsA, and AS patients treated with TNF-α inhibitors for at least 270 days between 2001 and 2011. Levels of TC, TG, LDL, and HDL and the AI were compared with baseline values at 0–6, 6–12, 12–18, and 18–24 months. Patients were further subdivided into three groups according to their HMG CoA reductase inhibitor (statin) treatment status in order to assess their effect on the results.ResultsThe records of 311 patients (152 RA, 90 PsA, and 69 AS) were reviewed. TC and TG increased following treatment with TNF-α inhibitors, from 180.85 ± 2.12 mg/dl and 116.00 ± 3.55 mg/dl at baseline to 188.12 ± 2.35 mg/dl (p = 0.02) and 132.02 ± 4.63 mg/dl at 0–6 months (p < 0.01), respectively, and to 184.88 ± 2.09 mg/dl (p = 0.02) and 129.36 ± 4.32 mg/dl at 18–24 months (p < 0.01), respectively. AI increased following treatment with TNF-α inhibitors, from –0.032 ± 0.017 at baseline to 0.004 ± 0.019 at 18–24 months (p < 0.01). LDL decreased significantly in patients who were treated with statins before and during the entire study period, from 119.97 ± 2.86 mg/dl at baseline to 104.02 ± 3.57 mg/dl at 18–24 months (p < 0.01), in contrast to an increase in LDL values in patients who did not receive statins during the study.ConclusionsTNF-α inhibitor treatment was associated with a significant increase in TC and TG levels and the AI. Adding statins to the treatment was associated with a significant decrease in LDL levels.

Clinical and Genetic Risk Factors Associated with Psoriatic Arthritis among Patients with Psoriasis

“…Interestingly, hypertriglyceridemia was negatively associated with PsA in predictive model 2. High triglyceride levels may be a marker of treatment with systemic medications, such as retinoids [ 23 ], methotrexate [ 24 ], and tumor necrosis factor-alpha inhibitors [ 25 – 27 ]; these medications have been associated with increased triglyceride levels and may be used to treat or delay the onset of PsA.…”

Impact of Treatment with Methotrexate and TNF Alpha Inhibitors on Insulin Resistance in Patients with Psoriasis

“…[12][13][14][15][16][17] Controversial data are available on the impact of treatment modalities on the lipid profile, insulin resistance and inflammatory parameters. [18][19][20][21][22] Boehncke et al evaluated the impacts of sys-temic anti-psoriatic therapy on the biomarkers of systemic inflammation. 17 They reported that a decrease in PASI scores was associated with a decrease of serum high sensitive-CRP levels, the vascular endothelial growth factor and resistin and an increase in adiponectin.…”

Anti-TNFα Biologics in the Pharmacotherapy of Rheumatoid Arthritis: Effectiveness and Safety of Infliximab, Adalimumab and Etanercept

“…Initially, anti-TNFα biologics were found to reduce the risk of cardiac diseases. 70 However, along with the reported increment of total cholesterol and low-density lipoprotein levels subsequent to anti-TNFα therapy, 71 they are considered to impose risk for MI and congestive heart failure.…”