| Effect of TNF inhibitors on lipid profile in rheumatoid arthritis: a systematic review with meta-analysis. | |
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MedLine Citation:
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PMID: 22267329 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Patients with rheumatoid arthritis (RA) are at increased risk of cardiovascular disease. Lipid changes related to inflammation have been described in RA. Tumour necrosis factor α (TNFα) inhibitor (TNFi) treatment is effective in controlling inflammation and decreasing the number of cardiovascular events.OBJECTIVE: To assess the change in lipid levels with TNFi treatment in patients with RA by systematic review and meta-analysis.METHODS: A Medline search was performed for articles published up to March 2011. Reports describing values for total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TGs), atherogenic index (AI) and apolipoprotein B/A (apoB/A) collected before and after TNFi initiation were included. Data were analysed according to short-, mid- and long-term treatment. Statistical analysis of pre-post data was performed by comprehensive meta-analysis. A random effects model was used when there was evidence of heterogeneity.RESULTS: The search retrieved 32 articles, of which 13 prospective before/after studies were analysed. Long-term TNFi treatment was associated with increased levels of HDL (+0.27 mmol/l, p<0.0001) and TC (+0.27 mmol/l, p=0.03), whereas LDL levels and AI remained unchanged. After long-term treatment, TG levels increased (+0.28 mmol/l, p<0.001) and apoB/A decreased (-0.3, p<0.0001).CONCLUSION: The presumed cardioprotective effects of TNFi in RA do not seem to be explained by quantitative lipid changes since long-term treatment has no effect on LDL levels or on AI. Increased HDL levels could have some beneficial effects, but this needs to be confirmed by prospective studies with long-term follow-up. |
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Authors:
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Claire Immediato Daïen; Yohan Duny; Thomas Barnetche; Jean-Pierre Daurès; Bernard Combe; Jacques Morel |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-20 |
Journal Detail:
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Title: Annals of the rheumatic diseases Volume: - ISSN: 1468-2060 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372355 Medline TA: Ann Rheum Dis Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1Département de Rhumatologie, Hôpital Lapeyronie, Université de Montpellier 1, Montpellier, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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