Lipid Profile of Rheumatoid Arthritis Patients Treated with Anti‐Tumor Necrosis Factor‐Alpha Drugs Changes According to Disease Activity and Predicts Clinical Response

Abstract

Patients with active rheumatoid arthritis (RA) frequently show an atherogenic lipid profile, which has been linked with the inflammatory reaction. Inflammatory cytokines, and particularly tumor necrosis factor-alpha (TNF-α), are implicated in the pathogenesis of both atherosclerosis and RA, and also involved in the development of the impaired lipid profile detected in active RA. Although anti-TNF-α agents have been proven effective in controlling joint damage and systemic inflammation, controversy remains about the effect of these drugs on the lipid profile; therefore, the aim of our study was to investigate the effect of anti-TNF-α treatment, in combination with disease-modifying anti-rheumatic drugs (DMARDs) and corticosteroid therapy, on the lipid profile of patients with active RA. Our data suggest that the combination anti-TNF-α/DMARDs/steroids do not significantly interfere with the lipid profile of RA patients. However, analysis of clinical response data showed that patients achieving low disease activity or remission seem to have a protective lipid profile, suggesting that better control of inflammation and disease activity can affect lipid metabolism. The available evidence indicates that high inflammation interferes with lipid metabolism, whereas good control of the chronic inflammatory state may positively influence the lipid profile and cardiovascular risk. Low cholesterol levels at baseline could predict a favorable outcome with anti-TNF-α treatment, but these data need to be confirmed by large prospective studies with long-term follow-up.

Impact of biological therapy on body composition of patients with Chron's disease

“…35 It is believed that a good control of the inflammatory state can positively influence the lipid concentration. 41 Some studies have suggested that in different chronic clinical conditions, the PA can be considered a marker of general health, nutritional status and prognosis. 42,43 Reduced PA values are associated with unfavorable disease progression and poor prognosis.…”

A psoriatic arthritis patient who developed hypertriglyceridemia while receiving adalimumab treatment

“…3 Many researchers have found out that patients with TNFa mediated inflammatory diseases had a higher risk for cardiovascular diseases. 3,8,9 Therefore, in concordance to these researches, treatment with TNF-a antagonists is expected to cause a decrease in TG concentration, therefore resulting an antiatherogenic modification which leads a rise in serum HLD-C. However, there are inconsistent data regarding anti TNF-a agent's effect on lipid profile.…”

Integrative Clinical, Molecular, and Computational Analysis Identify Novel Biomarkers and Differential Profiles of Anti-TNF Response in Rheumatoid Arthritis

“…Preceding studies demonstrated that these parameters were linked to the altered autoimmune and inflammatory status of RA patients (i.e., inflamed joints, elevated IgM and complement C4) (20,21), and/or were indicative of an active metabolic status (i.e., high creatinine) (22). Moreover, available evidence indicates that high inflammation interferes with lipid metabolism, so that hyperlipidemia is frequently associated to the adverse clinical outcome of the disease, and good control of the chronic inflammatory state may positively influence the lipid profile (23).…”