Influence of anti-tumour necrosis factor therapy on cardiovascular risk factors in patients with active rheumatoid arthritis

• Published in: Annals of the rheumatic diseases Vol. 64; no. 2; pp. 303 - 305
• Main Authors: Popa, C, Netea, M G, Radstake, T, Van der Meer, J W M, Stalenhoef, A F H, van Riel, P L C M, Barerra, P
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01-02-2005; BMJ; BMJ Publishing Group LTD
• Subjects: Adalimumab; anti-tumour necrosis factor α; Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Humanized; Antirheumatic Agents - therapeutic use; Arthritis, Rheumatoid - blood; Arthritis, Rheumatoid - complications; Arthritis, Rheumatoid - drug therapy; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; C reactive protein; C-Reactive Protein - metabolism; Cardiology. Vascular system; Cardiovascular Diseases - etiology; Cardiovascular Diseases - prevention & control; Cholesterol - blood; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Concise Report; CRP; DAS; Disease Activity Score; Diseases of the osteoarticular system; Double-Blind Method; HDL; Health risk assessment; high density lipoprotein; Humans; Inflammatory joint diseases; interleukin; Interleukin-6 - blood; LDL; lipoproteins; Low density lipoprotein; Medical sciences; Pharmaceutical industry; Rheumatoid arthritis; Risk Factors; TNFα; triglyceride; Tumor Necrosis Factor-alpha - antagonists & inhibitors; Tumor necrosis factor-TNF; tumour necrosis factor α; Human; Diseases of the osteoarticular system; Autoimmune disease; Cardiovascular disease; Inflammatory joint disease; Vascular disease; Rheumatoid factor; Chronic; Treatment; Tumor necrosis factor; Rheumatoid arthritis; Atherosclerosis; Risk factor
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.2004.023119

Background: Tumour necrosis factor (TNF) is known to increase the concentrations of interleukin (IL) 6 and C reactive protein (CRP) and to induce proatherogenic changes in the lipid profile and may increase the cardiovascular risk of patients with rheumatoid arthritis (RA) and other inflammatory disorders. Objective: To assess whether anti-TNF therapy modifies the cardiovascular risk profile in patients with RA. Methods: The lipoprotein spectrum and the inflammation markers CRP and IL6 were investigated in 33 patients with RA treated with human anti-TNF monoclonal antibodies (D2E7, adalimumab, Humira) and 13 patients with RA given placebo, before and after 2 weeks’ treatment. Results: In the anti-TNF treated group, the mean (SD) concentrations of HDL-cholesterol were significantly higher after 2 weeks’ treatment (0.86 (0.30) mmol/l v 0.98 (0.33) mmol/l, p<0.01), whereas LDL and triglyceride levels were not significantly changed. Additionally, a significant decrease in CRP (86.1 (54.4) mg/l v 35.4 (35.0) mg/l, p<0.0001), and IL6 (88.3 (60.5) pg/ml v 42.3 (40.7) pg/ml, p<0.001) concentrations was seen in this group. No changes in lipid profile, IL6, or CRP levels were seen in the placebo group. Conclusions: TNF neutralisation with monoclonal anti-TNF antibodies increased HDL-cholesterol levels and decreased CRP and IL6 levels after 2 weeks. Therefore this treatment may improve the cardiovascular risk profile of patients with RA.