The Effect of TNF-alpha Blocking Therapy on Lipid Levels in Rheumatoid Arthritis: A Meta-Analysis

Sijl, A.M. van; Peters, Mike J L; Knol, Dirk L.; Vet, Henrica C.W. de; Sattar, Naveed; Dijkmans, Ben A. C.; Smulders, Yvo M.; Nurmohamed, Michael T.

doi:10.1016/j.semarthrit.2011.04.003

Cited by 90 publications

(58 citation statements)

References 37 publications

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“…151,154 Anti-TNF therapy in patients with RA also modifies lipid levels from baseline, increasing total cholesterol, HDL cholesterol, triglycerides and possibly LDL cholesterol. 155 These changes probably reflect a normalization of lipid levels by suppression of inflammation. Moreover, the antiatherogenic properties of HDL cholesterol seem to be restored by TNF blockade.…”

Section: Biologic Dmardsmentioning

confidence: 99%

Cardiovascular comorbidity in rheumatic diseases

2015

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Patients with rheumatoid arthritis (RA) and other inflammatory joint diseases (IJDs) have an increased risk of premature death compared with the general population, mainly because of the risk of cardiovascular disease, which is similar in patients with RA and in those with diabetes mellitus. Pathogenic mechanisms and clinical expression of cardiovascular comorbidities vary greatly between different rheumatic diseases, but atherosclerosis seems to be associated with all IJDs. Traditional risk factors such as age, gender, dyslipidaemia, hypertension, smoking, obesity and diabetes mellitus, together with inflammation, are the main contributors to the increased cardiovascular risk in patients with IJDs. Although cardiovascular risk assessment should be part of routine care in such patients, no disease-specific models are currently available for this purpose. The main pillars of cardiovascular risk reduction are pharmacological and nonpharmacological management of cardiovascular risk factors, as well as tight control of disease activity.

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Section: Biologic Dmardsmentioning

confidence: 99%

Cardiovascular comorbidity in rheumatic diseases

2015

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“…It is clear that CV morbidity and mortality are reduced with the use of disease-modifying anti-rheumatic drugs (DMARDs) [11] and tumour necrosis factor inhibitors (TNFi) [12]. DMARDS appear to reduce TC/HDL-C [13,14], however, metaanalyses report conflicting results [15,16], suggesting a complex relationship. IR can be improved with DMARDs in established RA [17], but the effect of TNFi is unclear [18][19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Improvement in insulin resistance is greater when infliximab is added to methotrexate during intensive treatment of early rheumatoid arthritis—results from the IDEA study

et al. 2016

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Objectives: To determine the change in established biomarkers of cardiovascular (CV) risk, namely total cholesterol/high-density lipoprotein cholesterol ratio (TC/HDL-C), N-terminal pro-brain natriuretic peptide (NT-proBNP) and insulin resistance (IR) in patients with early rheumatoid arthritis (RA) treated with two different treat-to-target (T2T) strategies. Conclusions: When implementing a T2T approach, treatment of early RA was associated with improvement in TC/HDL-C, HOMA-IR and NT-proBNP, and a greater long-term improvement in HOMA-IR was seen in those treated with IFX. Methods3

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“…Data from numerous phase III clinical trials and post-marketing follow-up studies (to a maximum followup of around 4 years) have as yet shown no adverse change in CVD risk with tocilizumab therapy. As we detail in our review, however, there is increasing evidence that lipid changes following tocilizumab (as with other biologics [3]) in part reflect an inflammatory suppression effect, leading in turn to predictable elevation in LDL-and HDL-cholesterol. We say this since in the context of active RA, the normal relationship between hyperlipidaemia and CVD risk appears to be reversed (the so-called ''lipid paradox'' of RA).…”

Section: To the Editormentioning

confidence: 96%