Document Detail


Dyslipidemia and changes in lipid profiles associated with rheumatoid arthritis and initiation of anti-tumor necrosis factor therapy.
MedLine Citation:
PMID:  22504829     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the frequency of lipid testing in clinical practice and to explore the relationship between rheumatoid arthritis (RA), dyslipidemia, and other cardiovascular (CV) risk factors with RA treatment.
METHODS: Patients in this retrospective database study were ages ≥18 years and had ≥2 physician diagnoses for RA or osteoarthritis (OA; comparator group) between March 2004 and March 2008. Outcomes of interest included the percentage of RA and OA patients receiving lipid tests, lipid profiles (total cholesterol, low-density lipoprotein [LDL] cholesterol, and high-density lipoprotein [HDL] cholesterol) of RA versus OA patients, and lipid profiles of RA patients before and after initiation with a tumor necrosis factor (TNF) inhibitor. We used multivariable regression to control potential confounders between the cohorts.
RESULTS: Over a median ≥2-year followup, fewer RA patients than OA patients had ≥1 lipid test (62.0% [95% confidence interval (95% CI) 61.5-62.5] versus 69.8% [95% CI 69.5-70.1]). Mean total cholesterol and LDL cholesterol were each 4 mg/dl lower in the RA cohort (P < 0.0001); HDL cholesterol was similar between the cohorts. Across the RA cohort, 25.2% of patients had suboptimal LDL cholesterol levels (≥130 mg/dl). Among RA patients not receiving lipid-lowering therapy who initiated TNF inhibitor therapy (n = 96), mean total cholesterol and LDL cholesterol increased by 5.4 and 4.0 mg/dl, respectively.
CONCLUSION: Patients with RA were less likely to be tested for hyperlipidemia and had more favorable lipid profiles than patients with OA. TNF inhibitor therapy modestly increased all lipid parameters. Additional studies are needed to determine the effect of traditional CV risk factors and inflammation and the impact of biologic agents on CV outcomes in RA patients.
Authors:
Jeffrey R Curtis; Ani John; Onur Baser
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Arthritis care & research     Volume:  64     ISSN:  2151-4658     ISO Abbreviation:  Arthritis Care Res (Hoboken)     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-28     Completed Date:  2012-11-01     Revised Date:  2014-09-10    
Medline Journal Info:
Nlm Unique ID:  101518086     Medline TA:  Arthritis Care Res (Hoboken)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1282-91     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 by the American College of Rheumatology.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Antirheumatic Agents / adverse effects,  therapeutic use*
Arthritis, Rheumatoid / blood,  drug therapy*,  epidemiology,  immunology
Biological Markers / blood
Dyslipidemias / blood,  diagnosis,  drug therapy,  epidemiology*
Female
Humans
Hypolipidemic Agents / therapeutic use
Lipids / blood
Male
Middle Aged
Multivariate Analysis
Osteoarthritis / blood,  drug therapy*,  epidemiology,  immunology
Predictive Value of Tests
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Tumor Necrosis Factor-alpha / antagonists & inhibitors*,  metabolism
United States / epidemiology
Young Adult
Grant Support
ID/Acronym/Agency:
AR-053351/AR/NIAMS NIH HHS; K23 AR053351/AR/NIAMS NIH HHS; K23 AR053351-05/AR/NIAMS NIH HHS; R01 HS018517/HS/AHRQ HHS; R01-HS018517/HS/AHRQ HHS
Chemical
Reg. No./Substance:
0/Antirheumatic Agents; 0/Biological Markers; 0/Hypolipidemic Agents; 0/Lipids; 0/Tumor Necrosis Factor-alpha
Comments/Corrections
Comment In:
Arthritis Care Res (Hoboken). 2014 Aug;66(8):1270-1   [PMID:  24757091 ]
Arthritis Care Res (Hoboken). 2014 Aug;66(8):1271-2   [PMID:  24757074 ]

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