The effect of TNF-alpha blocking therapy on lipid levels in rheumatoid arthritis: A meta-analysis

van Sijl AM et al. – TNF-alpha blocking therapy has a modest effect on TC and HDLc levels in RA patients with no significant overall effect on the atherogenic index. Whether TNF-alpha blocking effects on qualitative lipid changes (structure and function) are more relevant to their presumed vascular benefits requires further study.

Methods

• Literature searched to identify studies assessing changes in TC, HDL, LDL, triglycerides, atherogenic index (ie, TC/HDL ratio), and apolipoprotein levels in response to TNF-alpha blocking therapy
• Weighted mean levels of lipids at different time points and subsequent changes in these lipid levels between these time points calculated with multivariate linear mixed models

Results

• Data available on TC in 15 studies encompassing 766 RA patients and on HDLc in 14 studies encompassing 736 RA patients
• TC increased significantly (maximum increase of 10%) and HDLc increased significantly in the first 2 to 6 weeks of therapy (maximum increase of 7%), after which it remained more or less stable
• Atherogenic index did not significantly change over time
• There was too limited information to evaluate changes in other lipids and apolipoproteins

[more...]