Effects of antirheumatic therapy on serum lipid levels in patients with rheumatoid arthritis: a prospective study.

Abstract

BACKGROUND:

Patients with newly diagnosed rheumatoid arthritis have adverse serum lipid profiles. We sought to determine the effects of treating rheumatoid arthritis with antirheumatic drugs on these abnormal lipid levels.

SUBJECTS AND METHODS:

We studied 42 patients with newly diagnosed rheumatoid arthritis who had not been treated with corticosteroids or disease-modifying antirheumatic drugs. We measured serum lipid profiles at baseline and 1 year later, and determined whether there were differences in the changes in lipid levels between patients who met the American College of Rheumatology criteria for a 20% improvement in rheumatoid arthritis and those who did not.

RESULTS:

Of the 42 patients, 27 (64%) met the criteria for a 20% improvement in rheumatoid arthritis during the 12-month study. In these patients, mean high-density lipoprotein (HDL) cholesterol levels increased by 21% (P <0.001), apolipoprotein A-I levels increased by 23% (P <0.001), and the ratio of low-density lipoprotein (LDL) cholesterol to HDL cholesterol level decreased by 13% (P = 0.10). There were significant between-group differences (responders-nonresponders) in the mean 12-month changes in HDL cholesterol levels (8.0 mg/dL; 95% confidence interval [CI]: 3 to 13 mg/dL; P = 0.002), apolipoprotein A-I levels (21 mg/dL; 95% CI: 8 to 33 mg/dL; P = 0.003), and the LDL cholesterol to HDL cholesterol ratio (-0.6; 95% CI: -0.1 to -1.0; P = 0.03), but not in LDL cholesterol, apolipoprotein B-100, or lipoprotein(a) levels.

CONCLUSION:

Active rheumatoid arthritis is associated with an adverse lipid profile that improves substantially following effective treatment of rheumatoid arthritis. This improvement may reduce the risk of cardiovascular disease.

• Authors: Yong-Beom Park, Hyon K Choi, Min-Young Kim, Won-Ki Lee, Jungsik Song, Dong-Kee Kim, Soo-Kon Lee
• Journal: The American journal of medicine (Am J Med) Vol. 113 Issue 3 Pg. 188-93 (Aug 15 2002) ISSN: 0002-9343 [Print] United States
• PMID: 12208376 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antirheumatic Agents
• Cholesterol, HDL
• Cholesterol, LDL
• Lipids
• Triglycerides
• C-Reactive Protein
• Methotrexate

Topics

• Adult
• Aged
• Analysis of Variance
• Antirheumatic Agents (administration & dosage)
• Arthritis, Rheumatoid (blood, diagnosis, drug therapy)
• C-Reactive Protein (analysis, drug effects)
• Chi-Square Distribution
• Cholesterol, HDL (blood, drug effects)
• Cholesterol, LDL (blood, drug effects)
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Humans
• Lipids (analysis, blood)
• Male
• Methotrexate (administration & dosage)
• Middle Aged
• Probability
• Prospective Studies
• Sensitivity and Specificity
• Severity of Illness Index
• Triglycerides (analysis, blood)