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

van Sijl, A.M., Peters, M.J.M., Knol, D.L., de Vet, R.H.C., Sattar, N. , Dijkmans, B.A.C., Smulders, Y.M. and Nurmohamed, M.T. (2011) The effect of TNF-alpha blocking therapy on lipid levels in rheumatoid arthritis: a meta-analysis. Seminars in Arthritis and Rheumatism, 41(3), pp. 393-400. (doi: 10.1016/j.semarthrit.2011.04.003)

Abstract

<p>Objectives: Changes in the lipid profile have been described in patients with rheumatoid arthritis (RA) following therapy with tumor necrosis factor (TNF)-alpha blocking agents. However, thus far, results have been inconsistent. Therefore, we investigated changes in lipid levels after TNFalpha blocking therapy using meta-analysis of published data.</p> <p>Methods: The literature was searched to identify studies assessing changes in total cholesterol (TC), high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol, triglycerides, atherogenic index (ie, TC/HDLc 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 were calculated with multivariate linear mixed models.</p> <p>Results: Data were 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. The atherogenic index did not significantly change over time. There was too limited information to evaluate changes in other lipids and apolipoproteins.</p> <p>Conclusions: 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.</p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Sattar, Professor Naveed
• Authors: van Sijl, A.M., Peters, M.J.M., Knol, D.L., de Vet, R.H.C., Sattar, N., Dijkmans, B.A.C., Smulders, Y.M., and Nurmohamed, M.T.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Seminars in Arthritis and Rheumatism
• ISSN: 0049-0172
• ISSN (Online): 1532-866X
• Published Online: 12 June 2011