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Dyslipidemia and changes in lipid profiles associated with rheumatoid arthritis and initiation of anti-TNF therapy
Arthritis Care & Research , 05/07/2012
Curtis JR et al. – Rheumatoid arthritis (RA) patients were less likely to be tested for hyperlipidemia and had more favorable lipid profiles than osteoarthritis (OA) patients. Tumor necrosis factor inhibitor (TNFi) therapy modestly increased all lipid parameters. Additional studies are needed to determine the effect of traditional cardiovascular (CV) risk factors, inflammation, and the impact of biologics on CV outcomes in RA patients.
Methods- Patients in the retrospective database study were ≥18 years old and had ≥2 physician diagnoses for RA or osteoarthritis (OA) [comparator group] between March 2004–March 2008.
- Outcomes of interest included the percentage of RA and OA patients receiving lipid tests, lipid profiles (total cholesterol [TC], low–density lipoprotein cholesterol [LDL–C], and high–density lipoprotein cholesterol [HDL–C]) of RA vs. OA patients, and lipid profiles of RA patients before and after initiation with a tumor necrosis factor inhibitor (TNFi).
- The authors used multivariable regression to control potential confounders between the cohorts.
- Over a median 2+ year follow–up, fewer RA patients than OA patients had at least one lipid test (62% [95% CI, 60–64] vs. 68% [95% CI, 65–71]).
- Mean TC and LDL–C were each 4 mg/dL lower in the RA cohort (P<0.0001); HDL–C was similar between cohorts.
- Across the RA cohort, 25.2% of patients had suboptimal LDL–C levels (≥130 mg/dL).
- Among RA patients not using lipid–lowering therapy who initiated TNFi therapy (n=96), mean TC and LDL–C increased by 5.4 and 4.0 mg/dL, respectively.