The study showed RA patients taking the tumour necrosis factor (TNF)-alpha blocker infliximab had an increased atherogenic index and higher level of total cholesterol a year after treatment was initiated.
TNF-alpha blockers may add to the increased cardiovascular risk RA patients are known to have. Cardiovascular disease is more common in RA patients than the general population.
Under NICE guidance, RA patients are offered infliximab or the TNF-alpha blocker etanercept in combination with methotrexate if they have failed to respond to two other disease modifying anti-rheumatic drugs including methotrexate.
For the study, plasma lipoprotein concentrations were assessed in 55 RA patients and 55 controls, showing no differences between the groups’ lipid profiles.
RA patients had a disease activity score above 3.2 and were starting therapy with infliximab.
At one year, 31 RA patients were reassessed for lipid profile. HDL cholesterol levels were similar to those at baseline and the atherogenic index was 4 per cent higher than baseline. Total cholesterol had increased from 5.55 mmol/l to 6.01 mmol/l.
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